MERCY HOSPITAL OF DEVILS LAKE: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HOSPITAL OF DEVILS LAKE (EIN 45-0227012)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-12
- IRS object ID
- 202241329349306209
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-12T14:41:10-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 470617373 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMONSPIRIT HEALTH | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 198 INVERNESS DRIVE WEST | AddressLine1Txt |
| City | ENGLEWOOD | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80112 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450227012 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF DEVILS LAKE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 7016622131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1031 SEVENTH STREET NE | AddressLine1Txt |
| City | DEVILS LAKE | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMBER STOWMAN | PersonNm |
| Person Title | VP OPERATIONAL FINANCE | PersonTitleTxt |
| Phone | 7016622131 | PhoneNum |
| Signature | 2022-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | AMBER | PersonFirstNm |
| Person Last | STOWMAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAMELA KROHN | PreparerPersonNm |
| PTIN | P01210500 | PTIN |
| Phone | 3032989100 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHI ST ALEXIUS HEALTH DEVILS LAKE HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | CHI MERCY HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARIANN DOELING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1031 SEVENTH STREET NE | AddressLine1Txt |
| City | DEVILS LAKE | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,072,108 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHISTALEXIUSHEALTH.ORG/LOCATIONS/DEVILS-LAKE | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1894 | FormationYr |
| Legal Domicile State | ND | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPITAL PROVIDES DIAGNOSTIC AND THERAPEUTIC CARE FOR THE POOR AND INDIGENT AND ALSO PROMOTES HEALTHIER COMMUNITIES WITH INNOVATIVE PROGRAMS THAT STRESS WELLNESS AND QUALITY OF LIFE FOR ALL AGES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 164 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $19,986 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,970,974 | PYContributionsGrantsAmt |
| CY Contributions Grants | $709,367 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,249,404 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,420,692 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,608,724 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,352,150 | CYInvestmentIncomeAmt |
| PY Other Revenue | $179,014 | PYOtherRevenueAmt |
| CY Other Revenue | $589,899 | CYOtherRevenueAmt |
| PY Total Revenue | $30,008,116 | PYTotalRevenueAmt |
| CY Total Revenue | $33,072,108 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $899 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,700 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,837,037 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,378,456 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $110,801 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,034,688 | PYOtherExpensesAmt |
| CY Other Expenses | $11,991,329 | CYOtherExpensesAmt |
| PY Total Expenses | $21,872,624 | PYTotalExpensesAmt |
| CY Total Expenses | $22,371,485 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,135,492 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,700,623 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $118,326,716 | TotalAssetsBOYAmt |
| Total Assets EOY | $142,191,028 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,631,828 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,367,013 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $103,694,888 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $130,824,015 | NetAssetsOrFundBalancesEOYAmt |
| Mission | AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,118,536 | ExpenseAmt |
| Grant | $1,700 | GrantAmt |
| Revenue | $23,420,692 | RevenueAmt |
| Desc | SEE SCHEDULE H | Desc |
| Total Program Service Expenses | $20,118,536 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 164 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ND | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMBER STOWMAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7016622131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1031 SEVENTH STREET NE | AddressLine1Txt |
| City | DEVILS LAKE | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|---|
| CLIFF ROBERTSON | |||||||||
| DIRECTOR/CSH SVP DIVISION OFFICER | 1.00 | 50.00 | Yes (X) | $0 | $2,330,702 | $46,702 | |||
| JEFFREY DROP | |||||||||
| DIRECTOR/CSH SVP DIVISION OFFICER | 1.00 | 50.00 | Yes (X) | $0 | $1,263,797 | $34,793 | |||
| JEANETTE WOJTALEWICZ | |||||||||
| DIRECTOR/CSH SVP DIVISION OFFICER | 1.00 | 50.00 | Yes (X) | $0 | $986,312 | $50,266 | |||
| KURT SCHLEY | |||||||||
| EX-OFFICIO DIRECTOR / MARKET PRESIDENT, CHI ST AL | 1.00 | 50.00 | $0 | $649,227 | $65,899 | Yes (X) | |||
| KEVIN DAHMEN | |||||||||
| FORMER SECRETARY/TREASURER | 1.00 | 40.00 | $0 | $474,992 | $54,610 | Yes (X) | |||
| MICHAEL CASSIDY MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $457,927 | $34,854 | |||
| TESSA MARBURGER MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $402,438 | $24,833 | |||
| GEORGE DUEBER | |||||||||
| PHYSICIAN - EMERGENCY MEDICINE | 40.00 | 0.00 | $382,569 | $0 | $40,769 | Yes (X) | |||
| ANDREW LANKOWICZ | |||||||||
| PRESIDENT | 1.00 | 40.00 | $0 | $266,125 | $28,214 | Yes (X) | |||
| STEPHEN CHENG | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $242,257 | $0 | $23,965 | Yes (X) | |||
| MARIANN DOELING | |||||||||
| INTERIM PRESIDENT | 1.00 | 50.00 | $0 | $226,835 | $28,972 | Yes (X) | |||
| STACEY KONZAK | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $139,246 | $0 | $17,496 | Yes (X) | |||
| KURT SARGENT | |||||||||
| VP OPERATIONAL FINANCE | 1.00 | 50.00 | $0 | $137,152 | $22,022 | Yes (X) | |||
| AARON JOHNSON | |||||||||
| VP PATIENT CARE SERVICES | 40.00 | 0.00 | $132,569 | $0 | $34,158 | Yes (X) | |||
| DAVID SCHMITT | |||||||||
| PHYSICIAN ASSISTANT | 40.00 | 0.00 | $131,015 | $0 | $8,096 | Yes (X) | |||
| SR MARY RUTH HUHN | |||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| CORRY KENNER | |||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL LEFOR | |||||||||
| CHAIR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MIKE MURPHY | |||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| KIRK SCHOEPP | |||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| KRISTI SCHWARTZ | |||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK SOGARD | |||||||||
| VICE CHAIR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JULIE TRAYNOR | |||||||||
| SECRETARY / TREASURER | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CURTIS WIESZ | |||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,027,656 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,195,507 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $515,649 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDEFIS INC | |||||
| 2121 N 117TH AVE STE 200 | OMAHA | NE | 68164 | VENDOR MANAGEMENT/STAFFING | $739,994 |
| ALTRU HEALTH SYSTEM | |||||
| PO BOX 6002 | GRAND FORKS | ND | 58206 | HEALTHCARE SERVICES | $715,367 |
| CLINICAL COLLEAGUES INC | |||||
| 1765 E NINE MILE RD SUITE 1-229 | PENSACOLA | FL | 32514 | CRNA SERVICES | $677,090 |
| KRAUS-ANDERSON CONSTRUCTION | |||||
| 501 S 8TH ST | MINNEAPOLIS | MN | 55404 | CONSTRUCTION SERVICES | $163,864 |
| UNIVERSITY OF NORTH DAKOTA | |||||
| 3501 UNIVERSITY AVE STOP 8157 | GRAND FORKS | ND | 58202 | CONTRACT SURGEON FEES | $136,686 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $60 | RelatedOrganizationsAmt |
| Government Grants | $605,619 | GovernmentGrantsAmt |
| All Other Contributions | $103,688 | AllOtherContributionsAmt |
| Total Contributions | $709,367 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES | 900099 | $23,274,792 | $23,274,792 |
| RENTAL INCOME | 900099 | $145,900 | $145,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,420,692 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,329,686 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $19,986 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,309,700 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,022,464 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,022,464 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,022,464 | TotalRevenueColumnAmt |
| Exclusion | $7,022,464 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PHARMACY SERVICES | 446110 | $419,832 | $0 | $0 | $419,832 |
| CAFETERIA | 722100 | $77,640 | $0 | $0 | $77,640 |
| SERVICES SOLD | 900099 | $77,579 | $0 | $0 | $77,579 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,848 | TotalRevenueColumnAmt |
| Exclusion | $14,848 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $589,899 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,072,108 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,420,692 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $19,986 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,922,063 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,700 | TotalAmt |
| Program Services | $1,700 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,110,867 | TotalAmt |
| Program Services | $7,786,432 | ProgramServicesAmt |
| Management And General | $243,326 | ManagementAndGeneralAmt |
| Fundraising | $81,109 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,345 | TotalAmt |
| Program Services | $399,692 | ProgramServicesAmt |
| Management And General | $12,490 | ManagementAndGeneralAmt |
| Fundraising | $4,163 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,201,148 | TotalAmt |
| Program Services | $1,153,103 | ProgramServicesAmt |
| Management And General | $36,034 | ManagementAndGeneralAmt |
| Fundraising | $12,011 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $650,096 | TotalAmt |
| Program Services | $624,092 | ProgramServicesAmt |
| Management And General | $19,503 | ManagementAndGeneralAmt |
| Fundraising | $6,501 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,548 | TotalAmt |
| Management And General | $27,548 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $413 | TotalAmt |
| Program Services | $392 | ProgramServicesAmt |
| Management And General | $21 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,913 | TotalAmt |
| Program Services | $1,913 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,933,136 | TotalAmt |
| Program Services | $5,597,062 | ProgramServicesAmt |
| Management And General | $336,074 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,301 | TotalAmt |
| Program Services | $1,292 | ProgramServicesAmt |
| Management And General | $30,686 | ManagementAndGeneralAmt |
| Fundraising | $323 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $431,539 | TotalAmt |
| Program Services | $384,846 | ProgramServicesAmt |
| Management And General | $44,751 | ManagementAndGeneralAmt |
| Fundraising | $1,942 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $853,269 | TotalAmt |
| Program Services | $580,223 | ProgramServicesAmt |
| Management And General | $273,046 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $446,221 | TotalAmt |
| Program Services | $414,986 | ProgramServicesAmt |
| Management And General | $26,773 | ManagementAndGeneralAmt |
| Fundraising | $4,462 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,129 | TotalAmt |
| Program Services | $7,029 | ProgramServicesAmt |
| Management And General | $1,826 | ManagementAndGeneralAmt |
| Fundraising | $274 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,610 | TotalAmt |
| Program Services | $1,481 | ProgramServicesAmt |
| Management And General | $113 | ManagementAndGeneralAmt |
| Fundraising | $16 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,460 | TotalAmt |
| Program Services | $2,337 | ProgramServicesAmt |
| Management And General | $123 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $921,816 | TotalAmt |
| Management And General | $921,816 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $914,276 | TotalAmt |
| Program Services | $895,990 | ProgramServicesAmt |
| Management And General | $18,286 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,412 | TotalAmt |
| Program Services | $80,789 | ProgramServicesAmt |
| Management And General | $34,623 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $1,799,597 | $1,709,617 | $89,980 | $0 |
| REPAIRS AND MAINTENANCE | $358,344 | $340,427 | $17,917 | $0 |
| DUES & SUBSCRIPTIONS | $84,345 | $80,128 | $4,217 | $0 |
| EDUCATION | $30,218 | $28,707 | $1,511 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,782 | TotalAmt |
| Program Services | $26,298 | ProgramServicesAmt |
| Management And General | $1,484 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,371,485 | TotalAmt |
| Program Services | $20,118,536 | ProgramServicesAmt |
| Management And General | $2,142,148 | ManagementAndGeneralAmt |
| Fundraising | $110,801 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,865 | BOYAmt |
| EOY | $54,883 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,958,044 | BOYAmt |
| EOY | $11,402,325 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,420,454 | BOYAmt |
| EOY | $9,229,368 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,587 | BOYAmt |
| EOY | $549,689 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,459 | BOYAmt |
| EOY | $21,660 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,293,111 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,202,230 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,463,753 | BOYAmt |
| EOY | $7,090,881 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,419,313 | BOYAmt |
| EOY | $113,442,552 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,241 | BOYAmt |
| EOY | $399,670 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,326,716 | BOYAmt |
| EOY | $142,191,028 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,244,520 | BOYAmt |
| EOY | $6,290,275 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,204,244 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,183,064 | BOYAmt |
| EOY | $5,076,738 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,631,828 | BOYAmt |
| EOY | $11,367,013 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,016,418 | BOYAmt |
| EOY | $129,971,898 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,470 | BOYAmt |
| EOY | $852,117 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,694,888 | BOYAmt |
| EOY | $130,824,015 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,326,716 | BOYAmt |
| EOY | $142,191,028 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $10,700,623 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $14,671,224 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,757,280 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $1,913 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $1,913 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 - DETAILED DESCRIPTION OF THE LOBBYING ACTIVI | FormAndLineReferenceDesc |
| Explanation | THE PORTION OF ORGANIZATION DUES THAT ARE RELATED TO LOBBYING ARE AS FOLLOWS: AMERICAN HOSPITAL ASSOCIATION - $730 CATHOLIC HEALTH ASSOCIATION - $388 NORTH DAKOTA HOSPITAL ASSOCIATION - $795 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $289,087 | BeginningYearBalanceAmt |
| End Year Balance | $289,087 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $289,087 | BeginningYearBalanceAmt |
| End Year Balance | $289,087 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $289,087 | BeginningYearBalanceAmt |
| End Year Balance | $289,087 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $289,087 | BeginningYearBalanceAmt |
| End Year Balance | $289,087 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $289,087 | BeginningYearBalanceAmt |
| End Year Balance | $289,087 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.48110 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.51890 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,057,226 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,673,776 | DepreciationAmt |
| Book Value | $2,383,450 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,772,473 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,879,300 | DepreciationAmt |
| Book Value | $3,893,173 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,463,412 | OtherCostOrOtherBasisAmt |
| Depreciation | $649,154 | DepreciationAmt |
| Book Value | $814,258 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,090,881 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CSH OPERATING INVESTMENT POOL | Desc |
| Book Value | $113,442,552 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $113,442,552 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY LIABILITIES | $4,777,729 |
| LEASE LIABILITY | $298,626 |
| ON PLAN SERVICE FEE LIABILITY | $383 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,076,738 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | MERCY HOSPITAL OF DEVILS LAKE USES ENDOWMENT FUNDS TO FURTHER ITS CHARITABLE PURPOSE OF PROVIDING DIAGNOSTIC AND THERAPEUTIC CARE FOR THE POOR AND INDIGENT. |
| PART X, LINE 2: | MERCY HOSPITAL OF DEVILS LAKE'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 652 | PersonsServedCnt |
| Total Community Benefit Expns | $666,682 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $666,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02980 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 652 | PersonsServedCnt |
| Total Community Benefit Expns | $666,682 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $666,682 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02980 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 2913 | PersonsServedCnt |
| Total Community Benefit Expns | $121,939 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $121,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 75 | PersonsServedCnt |
| Total Community Benefit Expns | $39,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,475 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 33 | PersonsServedCnt |
| Total Community Benefit Expns | $3,549 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,549 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 3021 | PersonsServedCnt |
| Total Community Benefit Expns | $164,963 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $164,963 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 3673 | PersonsServedCnt |
| Total Community Benefit Expns | $831,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $831,645 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03730 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,281 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,281 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $570 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $570 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $1,851 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,851 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,176,242 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,067,037 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,557,521 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,490,484 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF DEVILS LAKE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1031 SEVENTH ST NE | AddressLine1Txt |
| City | DEVILS LAKE | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/LOC | WebsiteAddressTxt |
| State License | STATE LICENSE NO.: 5012 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HOSPITAL OF DEVILS LAKE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY HOSPITAL OF DEVILS LAKE | PART V, SECTION B, LINE 5: THE HOSPITAL COLLECTED INPUT FROM RESIDENTS, COMMUNITY LEADERS, EMPLOYEES OF MERCY HOSPITAL, LAKE REGION DISTRICT HEALTH, AND COMMUNITY FOCUS GROUPS. A STEERING COMMITTEE CONSISTED OF THE HOSPITAL PRESIDENT, CEO OF THE SPIRIT LAKE CLINIC, HEALTH BOARD CHAIRMAN FOR SPIRIT LAKE TRIBAL HEALTH, ALTRU HEALTH SYSTEM, AND THE SOCIAL SERVICES DIRECTOR. |
| MERCY HOSPITAL OF DEVILS LAKE | PART V, SECTION B, LINE 6B: LAKE REGION DISTRICT HEALTH UNIT |
| MERCY HOSPITAL OF DEVILS LAKE | PART V, SECTION B, LINE 11: MERCY HOSPITAL HAS CONTINUED TO WORK ON ITS IMPLEMENTATION PLAN AS PART OF THE CHNA, WHICH INCLUDED ACCESS TO PROVIDERS, AFFORDABLE CARE, AND ACCESS TO SPECIALISTS. MERCY HOSPITAL ACQUIRED A PRIMARY CARE CLINIC IN 2018 AND HAS WORKED TO EXPAND ACCESS TO THE LAKE REGION AREA, BY CONTINUING THIS SERVICE. THE STAFF AT THE HOSPITAL REFER PATIENTS WITHOUT ACCESS TO PRIMARY CARE FROM THE EMERGENCY DEPARTMENT TO THE HOSPITAL'S CLINIC AS THEY ARE OFTEN ABLE TO ACCOMMODATE NEW PATIENTS. MERCY HOSPITAL EVALUATED PRICES FOR CERTAIN SERVICES, PRIMARILY RADIOLOGY, AND REDUCED OR MAINTAINED PRICES FOR CT, RADIOLOGY, AND MRI SERVICES TO MAKE THEM MORE AFFORDABLE FOR THESE SERVICES. THE HOSPITAL MUST RELY ON ALTRU TO BRING IN SPECIALISTS, AS THE HOSPITAL DOES NOT HAVE ACCESS TO THESE PROFESSIONALS; HOWEVER, THE HOSPITAL DOES CONTINUE TO CONTRACT FOR ONE WEEK A MONTH FOR A GENERAL SURGEON TO PROVIDE SERVICES TO PATIENTS REFERRED TO HIM. FINALLY, THE 2020 CORONAVIRUS ("COVID-19") PANDEMIC DICTATED MUCH OF THE YEAR AND CONTINUES. THE HOSPITAL HAS HAD TO IMPLEMENT STRATEGIES TO CONTINUE TO DELIVER CARE, PROVIDE A SAFE ENVIRONMENT FOR EMPLOYEES, AND CARE FOR BOTH INFECTED AND NON-INFECTED PATIENTS GETTING CARE FOR OTHER AILMENTS. COVID-19 REQUIRED THE HOSPITAL TO FOCUS ON PROVIDING BASIC CARE AND NOT REALLY BE ABLE TO EXPAND ON OTHER IMPLEMENTATION PLAN ITEMS, AS COVID PLACED A SIGNIFICANT BURDEN ON STAFF AND THE COMMUNITY IN ORDER TO TRY TO CONTAIN THE VIRUS TO PREVENT SPREAD, SICKNESS, AND EVEN DEATH. THIS ALSO IMPACTED THE HOSPITAL FINANCIALLY, DUE TO THE DROPS IN VOLUMES THAT WITHOUT THE FEDERAL GOVERNMENT'S ASSISTANCE WOULD HAVE REQUIRED DRACONIAN MEASURES FOR THE HOSPITAL TO CONTINUE TO PROVIDE CARE TO THE COMMUNITY. WE HOPE THAT WITH THE ROLLOUT OF THE VACCINE AND OTHER CARE, WE CAN SEE A RETURN TO WHATEVER THE NEW NORMAL IS WITH A NOVEL VIRUS IN THE PUBLIC. |
| MERCY HOSPITAL OF DEVILS LAKE | PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD-PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A CHI HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENTS |
| SCHEDULE H, PART V, SECTION B, LINE 10A | HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENTS |
| PART V, SECTION B, LINE 3E: | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE COMMUNITY'S SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE |
| SCHEDULE H, PART V, SECTION B, LINE 16B | HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE |
| SCHEDULE H, PART V, SECTION B, LINE 16C | HTTPS://WWW.CHISTALEXIUSHEALTH.ORG/PATIENTS-VISITORS/OUR-PATIENTS/FINANCIAL-ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - DEVILS LAKE CLINIC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 425 SOUTH COLLEGE DRIVE SUITE 14 | AddressLine1Txt |
| City | DEVILS LAKE | CityNm |
| State Abbreviation | ND | StateAbbreviationCd |
| ZIP | 58301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | PROVIDER BASED CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE ORGANIZATION'S COST ACCOUNTING SYSTEM WAS USED TO REPORT FINANCIAL ASSISTANCE AND COMMUNITY BENEFITS IN PART I, LINE 7. THE ORGANIZATION'S COST ACCOUNTING SYSTEM ADDRESSES ALL OF THE PATIENTS SERVED BY MERCY HOSPITAL OF DEVILS LAKE. |
| PART III, LINE 2: | THE ORGANIZATION HAS REPORTED BAD DEBT EXPENSE AT GROSS CHARGES WRITTEN OFF. THE ORGANIZATION'S BAD DEBT EXPENSE REPRESENTS AMOUNTS BILLED TO PATIENTS THAT WAS DEEMED UNCOLLECTIBLE AND DOES NOT INCLUDE ANY CHARGES THAT WERE ULTIMATELY REIMBURSED OR DISCOUNTED. PATIENT DISCOUNTS ARE RECORDED IN CONTRACTUAL ALLOWANCE OR FINANCIAL ASSISTANCE, AS APPROPRIATE, AS AN OFFSET TO GROSS REVENUE AND ARE NOT INCLUDED IN BAD DEBT EXPENSE. |
| PART III, LINE 3: | MERCY HOSPITAL OF DEVILS LAKE DOES NOT BELIEVE THAT ANY PORTION OF BAD DEBT EXPENSE COULD REASONABLY BE ATTRIBUTED TO PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE SINCE AMOUNTS DUE FROM THOSE INDIVIDUALS' ACCOUNTS WILL BE RECLASSIFIED FROM BAD DEBT EXPENSE TO CHARITY CARE WITHIN 30 DAYS FOLLOWING THE DATE THAT THE PATIENT IS DETERMINED TO QUALIFY FOR CHARITY CARE. |
| PART III, LINE 4: | MERCY HOSPITAL OF DEVILS LAKE DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS:COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS ARE PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEEN-MONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF THE CHANGE.SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. BAD DEBT EXPENSE FOR 2021 AND 2020 WAS NOT SIGNIFICANT. |
| PART III, LINE 8: | COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS.COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. MERCY HOSPITAL OF DEVILS LAKE'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $1,490,484 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS. |
| PART III, LINE 9B: | THE ORGANIZATION'S BILLING AND COLLECTIONS POLICY APPLIES TO ALL INDIVIDUALS PRESENTING FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE. THE POLICY CONTAINS PROVISIONS FOR COLLECTING AMOUNTS DUE FROM THOSE PATIENTS WHO THE ORGANIZATION KNOWS TO QUALIFY FOR FINANCIAL ASSISTANCE EITHER THROUGH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS OR THROUGH PRESUMPTIVE ELIGIBILITY PROCESSES. BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS (ECAS) TO OBTAIN PAYMENT FOR EMCARE, HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. IN NO EVENT WILL AN ECA BE INITIATED PRIOR TO 120 DAYS FROM THE DATE THE FACILITY PROVIDES THE FIRST POST-DISCHARGE BILLING STATEMENT (I.E., DURING THE NOTIFICATION PERIOD) UNLESS ALL REASONABLE EFFORTS HAVE BEEN MADE.HOSPITAL FACILITIES WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HAS INITIALLY APPLIED FOR FINANCIAL ASSISTANCE, AND THE HOSPITAL FACILITY HAS NOT YET MADE REASONABLE EFFORTS WITH RESPECT TO THE ACCOUNT. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. PATIENTS WHO QUALIFY FOR MEDICAID ARE PRESUMED TO QUALIFY FOR FULL CHARITY WRITE OFF. ANY CHARGES FOR DAYS OR SERVICES WRITTEN OFF (EXCLUDING MEDICAID DENIALS RELATED TO TIMELINESS OF BILLING, INSUFFICIENT MEDICAL RECORD DOCUMENTATION, MISSING INVOICES, AUTHORIZATION, OR ELIGIBILITY ISSUES) AS A RESULT OF A MEDICAID ARE BOOKED AS CHARITY.SOME MEDICAID PLANS OFFER COVERAGE FOR A LIMITED OR RESTRICTED LIST OF SERVICES. IF A PATIENT IS ELIGIBLE FOR MEDICAID, ANY CHARGES FOR DAYS OR SERVICES NOT COVERED BY THE PATIENT'S COVERAGE MAY BE WRITTEN OFF TO CHARITY WITHOUT A COMPLETED APPLICATION. THIS DOES NOT INCLUDE ANY SHARE OF COST (SOC) OR OTHER PATIENT COST-SHARING AMOUNTS SUCH AS DEDUCTIBLES OR COPAYMENTS, AS SUCH COSTS ARE DETERMINED BY THE STATE TO BE AN AMOUNT THAT THE PATIENT MUST PAY BEFORE THE PATIENT IS ELIGIBLE FOR MEDICAID. HEALTH AND HUMAN SERVICES (HSS) USES THE TERM "SPEND DOWN" INSTEAD OF SHARE OF COST.ALL COLLECTION ACTIVITIES CONDUCTED BY THE FACILITY, A DESIGNATED SUPPLIER, OR ITS THIRD-PARTY COLLECTION AGENTS WILL BE IN CONFORMANCE WITH ALL FEDERAL AND STATE LAWS GOVERNING DEBT COLLECTION PRACTICES. ALL THIRD-PARTY AGREEMENTS GOVERNING COLLECTION AND RECOVERY ACTIVITIES MUST INCLUDE A PROVISION REQUIRING COMPLIANCE WITH THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE AND BILLING AND COLLECTIONS POLICY AND INDEMNIFICATION FOR FAILURES AS A RESULT OF ITS NONCOMPLIANCE. THIS INCLUDES, BUT IS NOT LIMITED TO, AGREEMENTS BETWEEN THIRD PARTIES WHO SUBSEQUENTLY SELL OR REFER DEBT OF THE HOSPITAL FACILITY. |
| PART VI, LINE 2: | THE ORGANIZATION ASSESSES THE NEEDS OF THE COMMUNITY BY PROVIDING CARE TO PATIENTS 24 HOURS A DAY REGARDLESS OF THEIR ABILITY TO PAY. THE WORK DONE BY THE EMPLOYEES OF THE ORGANIZATION PROVIDES INSIGHT INTO THE NEEDS OF THE COMMUNITY. FOR EXAMPLE, THE PROVIDERS ARE MEASURED BASED ON OUTCOMES RELATED TO HYPERTENSION AND DIABETES, SO VARIANCES IN THE PROVIDERS ABILITY TO CARE FOR INDIVIDUALS AND MEET TARGETS PROVIDES A QUANTITATIVE INSIGHT INTO THE COMMUNITY HEALTH. ADDITIONALLY, WITH A RELATIVELY RECENT CHNA, WE USE THAT DOCUMENT AND THE IMPLEMENTATION PLAN TO DETERMINE THE COMMUNITY HEALTH. LASTLY, WITH COVID-19, MERCY HOSPITAL HAS TAKEN A LEADERSHIP ROLE IN PROVIDING SERVICES TO THE COMMUNITY, SO THE HOSPITAL HAS ENGAGED IN BROAD TESTING OF THE COMMUNITY, ALONG WITH LAKE REGIONS DISTRICT HEALTH UNIT, AS WELL AS, VACCINATION ROLLOUT. |
| PART VI, LINE 3: | NOTIFICATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE FROM CHI HOSPITAL ORGANIZATIONS SHALL BE DISSEMINATED BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: - CONSPICUOUS PUBLICATION OF NOTICES IN PATIENT BILLS; - NOTICES POSTED IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING/REGISTRATION DEPARTMENTS, BUSINESS OFFICES, AND AT OTHER PUBLIC PLACES AS A HOSPITAL FACILITY MAY ELECT; AND - PUBLICATION OF A SUMMARY OF THIS POLICY ON THE HOSPITAL FACILITY'S WEBSITE AND AT OTHER PLACES WITHIN THE COMMUNITIES SERVED BY THE HOSPITAL FACILITY AS IT MAY ELECT. SUCH NOTICES AND SUMMARY INFORMATION SHALL INCLUDE A CONTACT NUMBER AND SHALL BE PROVIDED IN ENGLISH, SPANISH, AND OTHER PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVED BY AN INDIVIDUAL HOSPITAL FACILITY, AS APPLICABLE. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE CHI HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.IN ADDITION, HOSPITAL REGISTRATION CLERKS ARE TRAINED TO PROVIDE CONSULTATION TO THOSE WHO HAVE NO INSURANCE OR POTENTIALLY INADEQUATE INSURANCE CONCERNING THEIR FINANCIAL OPTIONS INCLUDING APPLICATION FOR MEDICAID AND FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. COUNSELORS ASSIST MEDICARE ELIGIBLE PATIENTS IN ENROLLMENT BY PROVIDING REFERRALS TO THE APPROPRIATE GOVERNMENT AGENCIES. ONCE IT IS DETERMINED THAT THE PATIENT DOES NOT QUALIFY FOR ANY THIRD PARTY FUNDING, THE PATIENT IS VERBALLY NOTIFIED ABOUT THE EXISTENCE OF FINANCIAL ASSISTANCE APPLICATION AND ADDITIONAL SCREENING TAKES PLACE BY A HOSPITAL EMPLOYEE TO DETERMINE IF THE PATIENT IS ELIGIBLE FOR CHARITY SERVICE PRIOR TO DISCHARGE. UPON REGISTRATION (AND ONCE ALL EMTALA REQUIREMENTS ARE MET), PATIENTS WHO ARE IDENTIFIED AS UNINSURED (AND NOT COVERED BY MEDICARE OR MEDICAID) ARE PROVIDED WITH A PACKET OF INFORMATION THAT ADDRESSES THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY OF THAT POLICY, AND AN APPLICATION FOR ASSISTANCE. HOSPITAL REGISTRATION CLERKS READ THE ORGANIZATION'S MEDICAL ASSISTANCE POLICY TO THOSE WHO APPEAR TO BE INCAPABLE OF READING, AND PROVIDE TRANSLATORS FOR NON-ENGLISH-SPEAKING INDIVIDUALS. PATIENTS THAT HAVE BEEN DISCHARGED PRIOR TO CHARITY SCREENING, SUCH AS EMERGENCY ROOM PATIENTS, RECEIVE A WRITTEN NOTIFICATION OF POSSIBLE ELIGIBILITY FOR SERVICES. IF THE PATIENT IS DETERMINED NOT TO BE ELIGIBLE FOR GOVERNMENT ASSISTANCE, HE/SHE MAY NOTIFY THE HOSPITAL THAT THEY SEEK CHARITY ASSISTANCE. THE APPROPRIATE CHARITY FORM IS SENT TO THE PATIENT/GUARANTOR FOR COMPLETION AND THEN RETURNED TO THE HOSPITAL FOR EVALUATION AND QUALIFICATION. ONCE DETERMINATION OF ELIGIBILITY IS MADE, THE PATIENT IS SENT A NOTICE INFORMING HIM/HER IF THEY QUALIFY FOR FULL, PARTIAL, OR NO CHARITY CARE SERVICES.HOSPITAL FACILITIES MUST MAKE REASONABLE EFFORTS THROUGH ITS BILLING AND COLLECTIONS PROCESSES, PURSUANT TO TREAS. REG. 1.501(R)-6(C), TO DETERMINE WHETHER ANY INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 4: | MERCY HOSPITAL IS LOCATED IN A COMMUNITY THAT IS DIVERSE IN ITS INDUSTRIES INCLUDING: TOURISM, FISHING, MANUFACTURING, A NEARBY CASINO, BANKING, AND AGRICULTURE. THE HOSPITAL IS LOCATED IN DEVILS LAKE, NORTH DAKOTA WITH A POPULATION OF OVER 7,300 WITH A SERVICE AREA OF APPROXIMATELY 15,000. THE COMMUNITY SITS ON THE HIGHWAY CORRIDOR BETWEEN GRAND FORKS, NORTH DAKOTA AND MINOT, NORTH DAKOTA, WHICH BOTH CONTAIN UNITED STATE AIR FORCE BASES. THE COMMUNITY IS THE LARGEST TOWN NEXT TO THE SPIRIT LAKE INDIAN RESERVATION, WHICH PROVIDES MEDICAL SERVICES TO THEIR COMMUNITY, SUCH AS A CLINIC, AMBULANCE SERVICES, AND NUTRITIONAL SUPPORT; HOWEVER, THE HOSPITAL PROVIDES SIGNIFICANT CARE TO THE MEMBERS FOR EMERGENCY AND ADVANCED ANCILLARY SERVICES. MERCY HOSPITAL IS THE ONLY HOSPITAL SURROUNDING DEVILS LAKE BY ABOUT 1 HOUR TRAVEL DISTANCE AND ONE OF THE FEW HOSPITALS IN THE STATE TO DELIVER BABIES, WHICH IS CLOSER TO 90 MINUTES FOR BIRTHING SERVICES. THE 2017 MEDIAN AVERAGE INCOME FOR THE SERVICE AREA OF MERCY HOSPITAL IS APPROXIMATELY $52,756, WHICH IS BELOW THE NORTH DAKOTA AVERAGE OF $61,285. THE HOSPITAL PAYER MIX FOR FY21 WAS 33.55% FOR MEDICARE AND MEDICAID WAS 29.01%. THE ORGANIZATION PROVIDED $666,682 IN CHARITY CARE IN FY21 AND HAD $1,176,242 OF BAD DEBT, WHICH IN A WAY IS ANOTHER MEASURE OF CHARITY CARE GIVEN THE UNLIKELIHOOD THAT THE MONEY WILL ULTIMATELY MIGHT NOT BE RECEIVED. |
| PART VI, LINE 5: | THE HOSPITAL PROMOTES HEALTH WITHIN THE COMMUNITY BY USING FUNDS TO PROVIDE CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, EDUCATING THE PUBLIC ABOUT COVID-19 THROUGH SOCIAL MEDIA, RADIO ANNOUNCEMENTS, INTERVIEWS AND CONTENT GENERATION WITH THE MEDIA, AND MAINTAINING OPERATIONS GIVEN THE PANDEMIC. THE HOSPITAL HAS A PATIENT CARE ADVISORY COUNCIL, QUALITY AND VALUES COMMITTEE OF THE BOARD OF DIRECTORS, BOARD OF DIRECTORS, WHICH INCLUDES LOCAL REPRESENTATION. PRIOR TO COVID, PRIOR TO HOSPITAL RESTRICTIONS DUE TO COVID-19 BABY AND I CLASSES FOR MOTHERS TO EDUCATE THEM ON CARING FOR NEWBORNS, PARTICIPATING AND FUNDING COMMUNITY EVENTS, 4TH OF JULY CELEBRATIONS, AND WORKING WITH LOCAL SCHOOLS TO SUPPORT HEALTHY LIVING. |
| PART VI, LINE 6: | THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. COMMONSPIRIT HEALTH IS COMPRISED OF MORE THAN 1,500 CARE SITES, CONSISTING OF 140 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2021, COMMONSPIRIT HEALTH PROVIDED MORE THAN $2.5 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $5.1 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.25 BILLION IN FISCAL YEAR 2021, HAS TOTAL ASSETS OF APPROXIMATELY $54.87 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | ND |
| SCHEDULE H, PART I, LINE 3C - FINANCIAL ASSISTANCE | UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: -THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($35.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($35) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. -THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 300% OF THE FPG. -THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. -THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: -RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; -HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC; -PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); -FOOD STAMP ELIGIBILITY; -SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; -ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); -LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR -PATIENT IS DECEASED WITH NO KNOWN ESTATE. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLIFF ROBERTSON | ||||||||||||||
| DIRECTOR/CSH SVP DIVISION OFFICER | $0 | $1,011,674 | $0 | $921,351 | $0 | $397,677 | $0 | $16,975 | $0 | $29,727 | $0 | $2,377,404 | $0 | $157,178 |
| JEFFREY DROP | ||||||||||||||
| DIRECTOR/CSH SVP DIVISION OFFICER | $0 | $692,085 | $0 | $430,582 | $0 | $141,130 | $0 | $16,844 | $0 | $17,949 | $0 | $1,298,590 | $0 | $0 |
| JEANETTE WOJTALEWICZ | ||||||||||||||
| DIRECTOR/CSH SVP DIVISION OFFICER | $0 | $553,985 | $0 | $277,663 | $0 | $154,664 | $0 | $17,649 | $0 | $32,617 | $0 | $1,036,578 | $0 | $49,946 |
| KURT SCHLEY | ||||||||||||||
| EX-OFFICIO DIRECTOR / MARKET PRESID | $0 | $425,434 | $0 | $178,127 | $0 | $45,666 | $0 | $39,610 | $0 | $26,289 | $0 | $715,126 | $0 | $39,692 |
| KEVIN DAHMEN | ||||||||||||||
| FORMER SECRETARY/TREASURER | $0 | $411,065 | $0 | $61,995 | $0 | $1,932 | $0 | $25,575 | $0 | $29,035 | $0 | $529,602 | $0 | $0 |
| MICHAEL CASSIDY MD | ||||||||||||||
| DIRECTOR | $0 | $426,215 | $0 | $0 | $0 | $31,712 | $0 | $17,150 | $0 | $17,704 | $0 | $492,781 | $0 | $0 |
| TESSA MARBURGER MD | ||||||||||||||
| DIRECTOR | $0 | $392,301 | $0 | $0 | $0 | $10,137 | $0 | $16,544 | $0 | $8,289 | $0 | $427,271 | $0 | $0 |
| GEORGE DUEBER | ||||||||||||||
| PHYSICIAN - EMERGENCY MEDICINE | $370,849 | $0 | $10,000 | $0 | $1,720 | $0 | $17,586 | $0 | $23,183 | $0 | $423,338 | $0 | $0 | $0 |
| ANDREW LANKOWICZ | ||||||||||||||
| PRESIDENT | $0 | $227,899 | $0 | $23,227 | $0 | $14,999 | $0 | $27,110 | $0 | $1,104 | $0 | $294,339 | $0 | $10,700 |
| STEPHEN CHENG | ||||||||||||||
| PHYSICIAN | $238,104 | $0 | $0 | $0 | $4,153 | $0 | $14,952 | $0 | $9,013 | $0 | $266,222 | $0 | $0 | $0 |
| MARIANN DOELING | ||||||||||||||
| INTERIM PRESIDENT | $0 | $158,752 | $0 | $20,328 | $0 | $47,755 | $0 | $16,470 | $0 | $12,502 | $0 | $255,807 | $0 | $0 |
| STACEY KONZAK | ||||||||||||||
| PHYSICIAN ASSISTANT | $131,933 | $0 | $3,333 | $0 | $3,980 | $0 | $8,314 | $0 | $9,182 | $0 | $156,742 | $0 | $0 | $0 |
| KURT SARGENT | ||||||||||||||
| VP OPERATIONAL FINANCE | $0 | $126,312 | $0 | $5,072 | $0 | $5,768 | $0 | $10,335 | $0 | $11,687 | $0 | $159,174 | $0 | $0 |
| AARON JOHNSON | ||||||||||||||
| VP PATIENT CARE SERVICES | $126,223 | $0 | $5,160 | $0 | $1,186 | $0 | $8,884 | $0 | $25,274 | $0 | $166,727 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | DURING THE CALENDAR YEAR 2020, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4A: | FOR REPORTABLE INDIVIDUALS EMPLOYED PRIOR TO 2019, POST-TERMINATION PAYMENTS ARE ADDRESSED IN EXECUTIVE EMPLOYMENT AGREEMENTS FOR EMPLOYEES AT THE LEVEL OF VICE PRESIDENT AND ABOVE. THESE EMPLOYMENT AGREEMENTS REQUIRE THAT IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT AGREEMENT. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. OFFICERS, KEY EMPLOYEES AND CERTAIN HIGHLY COMPENSATED EMPLOYEES WHO BEGAN EMPLOYMENT AFTER NOVEMBER 1ST OF 2019 ARE COVERED BY THE COMMONSPIRIT HEALTH EXECUTIVE SEVERANCE POLICY. THIS POLICY PROVIDES FOR SEVERANCE PAY WHICH VARIES BASED UPON THE EXECUTIVE'S POSITION LEVEL, IN THE EVENT OF A POSITION ELIMINATION OR OTHER QUALIFYING EVENT, IN ACCORDANCE WITH THE GUIDELINES OF THE EXECUTIVE SEVERANCE POLICY. AN EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT SHALL CONTROL WHERE THE SEVERANCE PAY AMOUNTS IN THE POLICY CONFLICT WITH THE EXECUTIVE'S WRITTEN EMPLOYMENT OR SEVERANCE AGREEMENT. IN ORDER FOR THE EXECUTIVE TO RECEIVE POST-TERMINATION PAYMENTS, THESE INDIVIDUALS MUST EXECUTE A GENERAL RELEASE AND SETTLEMENT OF CLAIMS. POST-TERMINATION PAYMENT ARRANGEMENTS ARE PERIODICALLY REVIEWED FOR OVERALL REASONABLENESS IN LIGHT OF THE EXECUTIVE'S OVERALL COMPENSATION PACKAGE. |
| PART I, LINE 4B: | DURING THE 2020 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2020 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: JEANETTE M WOJTALEWICZ, $71,692; CLIFF ROBERTSON, $186,901; KURT RONALD SCHLEY, $39,903; ANDREW JOSEPH LANKOWICZ, $10,756. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2020 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2020, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: JEFFREY DROP, $113,534; JEANETTE M WOJTALEWICZ, $77,144; CLIFF ROBERTSON, $195,187; MARIANN K DOELING, $9,477 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | PURSUANT TO SECTION 8.6 OF THE BYLAWS OF MERCY HOSPITAL OF DEVILS LAKE, THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT AND CEO, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE, AND TWO VOTING MEMBERS APPOINTED BY THE BOARD OF DIRECTORS. EACH INDIVIDUAL APPOINTED TO THE EXECUTIVE COMMITTEE SHALL SERVE FOR A TERM OF ONE YEAR OR UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION. PURSUANT TO SECTION 8.1 OF THE CORPORATION'S BYLAWS, COMMITTEES, SUCH AS THE EXECUTIVE COMMITTEE, THAT ARE GRANTED THE AUTHORITY TO ACT ON BEHALF OF THE BOARD OF DIRECTORS MAY INCLUDE ONLY DIRECTORS OF THE CORPORATION. FURTHER, PURSUANT TO SECTION 8.6 OF THE CORPORATION'S BYLAWS, THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE ALSO POSSESSES THE POWER TO TRANSACT ROUTINE BUSINESS OF THE CORPORATION IN THE INTERIM PERIOD BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | ACCORDING TO THE BYLAWS OF MERCY HOSPITAL OF DEVILS LAKE, THE ENTITY'S SOLE MEMBER IS COMMONSPIRIT HEALTH, A COLORADO NONPROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS OF THE CORPORATION SHALL BE APPOINTED BY THE CORPORATE MEMBER NO LATER THAN JUNE 30 OF EACH YEAR. THE NAMES AND QUALIFICATIONS OF EACH INDIVIDUAL ACCEPTED BY THE BOARD OF DIRECTORS SHALL BE SUBMITTED TO THE CORPORATE MEMBER, WHO SHALL APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE CORPORATE MEMBER'S BYLAWS AND WITH ENDORSEMENT OF THE SENIOR VICE PRESIDENT OF OPERATIONS. THE CORPORATE MEMBER MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS SHOULD THE BOARD FAIL TO FURNISH THE CORPORATE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD OF DIRECTORS OF THE CORPORATION. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION'S CORPORATE MEMBER IS COMMONSPIRIT HEALTH. PURSUANT TO SECTION 5.4.1 OF THE ORGANIZATION'S BYLAWS, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE RESERVED TO THE COMMONSPIRIT HEALTH BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE COMMONSPIRIT HEALTH CHIEF EXECUTIVE OFFICER: -SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF THE MERCY HOSPITAL OF DEVILS LAKE -AMENDMENT OF THE CORPORATE DOCUMENTS OF THE MERCY HOSPITAL OF DEVILS LAKE -APPROVE MEMBERS OF THE MERCY HOSPITAL OF DEVILS LAKE BOARD -REMOVAL OF A MEMBER OF THE GOVERNING BODY OF THE MERCY HOSPITAL OF DEVILS LAKE -APPROVAL OF ISSUANCE OF DEBT BY MERCY HOSPITAL OF DEVILS LAKE -APPROVAL OF PARTICIPATION OF MERCY HOSPITAL OF DEVILS LAKE IN A JOINT VENTURE -APPROVAL OF FORMATION OF A NEW CORPORATION BY MERCY HOSPITAL OF DEVILS LAKE -APPROVAL OF A MERGER INVOLVING THE MERCY HOSPITAL OF DEVILS LAKE -APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE MERCY HOSPITAL OF DEVILS LAKE -TO REQUIRE THE TRANSFER OF ASSETS BY THE MERCY HOSPITAL OF DEVILS LAKE TO COMMONSPIRIT HEALTH TO ACCOMPLISH COMMONSPIRIT HEALTH'S GOALS AND OBJECTIVES, AND TO SATISFY COMMONSPIRIT HEALTH DEBTS. -ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR MERCY HOSPITAL OF DEVILS LAKE PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, COMMONSPIRIT HEALTH MAY, IN EXERCISE OF ITS APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE. (CHCF RESERVED RIGHTS) EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION OR THE LAWS OF THE STATE OF ORGANIZATION, CATHOLIC HEALTH CARE FEDERATION ("CHCF") SHALL HAVE SUCH RIGHTS AS ARE RESERVED TO THE CORPORATE MEMBER, ACTING IN ITS CAPACITY AS THE MEMBERSHIP BODY OF CHCF, UNDER THE GOVERNANCE MATRIX. |
| FORM 990, PART VI, SECTION B, LINE 11B | ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE VP OPERATIONAL FINANCE FOR MERCY HOSPITAL OF DEVILS LAKE. THE VP OPERATIONAL FINANCE PROVIDES THE RETURN TO THE EXECUTIVE ASSISTANT WHO HANDLES BOARD CORRESPONDENCE. THE EXECUTIVE ASSISTANT FORWARDS TO THE BOARD PRIOR TO FILING WITH THE IRS. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD, THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NONSUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RESUBMITTED TO THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT") IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. THE POLICY WAS LAST UPDATED DURING THE TAX YEAR ENDED 6/30/2021. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY. - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP (WHICH INCLUDES KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE). DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO. |
| FORM 990, PART VI, SECTION B, LINE 15 | LINE 15A: THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION WAS PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION THE COMMONSPIRIT HEALTH BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR APPROVING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES (INCLUDING THE PRESIDENT/CEO). THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EXECUTIVES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES AN INDEPENDENT CONSULTANT AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF STEWARDSHIP TRUSTEES. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED. LINE 15B: DURING THE TAX YEAR ENDED 6/30/2021, NO OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION. THEREFORE, THESE QUESTIONS ARE MORE APPROPRIATELY ANSWERED AS N/A. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS ARE INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.COMMONSPIRIT.ORG. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 5,597,062. MANAGEMENT AND GENERAL EXPENSES 336,074. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,933,136. |
| FORM 990, PART XI, LINE 9: | REALLOCATION OF CARES ACT REVENUE 1,729,844. INTERCOMPANY TRANSACTIONS 27,539. OTHER CHANGE IN NET ASSETS -103. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (219 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT CREIGHTON CLINIC | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470765154 | HOSPITAL | NE | 501(C)(3) | LINE 3 | ACH | 0 | |
| ALEGENT CREIGHTON HEALTH | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470757164 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM | |||||||||||
| 7500 MERCY RD | OMAHA | NE | 68124 | 470484764 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - COMM MEM HOSP OF MO VALLEYIA | |||||||||||
| 631 N 8TH ST | MISSOURI VALLEY | IA | 51555 | 420776568 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - IMMANUEL MEDICAL CENTER | |||||||||||
| 6901 N 72ND ST | OMAHA | NE | 68122 | 470376615 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER | |||||||||||
| 104 W 17TH ST | SCHUYLER | NE | 68661 | 470399853 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA | |||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 420782518 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ALVERNA APARTMENTS | |||||||||||
| 300 SE 8TH AVE | LITTLE FALLS | MN | 56345 | 411351177 | LTERM CARE | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| APPLETREE COURT | |||||||||||
| 601 OAK ST | BRECKENRIDGE | MN | 56520 | 411850500 | SENIOR LIVING | MN | 501(C)(3) | LINE 10 | SFH | 0 | |
| ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 345 S HALCYON RD | ARROYO GRANDE | CA | 93420 | 203256066 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| BAKERSFIELD MEMORIAL HOSPITAL | |||||||||||
| 420 34TH STREET | BAKERSFIELD | CA | 93301 | 951802779 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| BARROW NEUROLOGICAL FOUNDATION | |||||||||||
| 350 WEST THOMAS ROAD | PHOENIX | AZ | 85013 | 860174371 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 7 | DH | 0 | |
| BAYLOR ST LUKE'S HEALTH VENTURES | |||||||||||
| 17200 ST LUKES WAY STE 170 | THE WOODLANDS | TX | 77384 | 274499340 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| BAYLOR ST LUKE'S MEDICAL GROUP | |||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760458535 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | BSLHV | 0 | |
| BORNEMANN HEALTHCARE CORPORATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232187242 | INACTIVE | PA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| BRAZOSPORT HEALTH FOUNDATION INC | |||||||||||
| 1 WEST WAY CT | LAKE JACKSON | TX | 77566 | 760080110 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 12A, I | TCHB | 0 | |
| BRAZOSPORT REGIONAL PHYSICIAN SERVICES | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 800240261 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | TCHB | 0 | |
| BURLESON ST JOSEPH HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742759890 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| BURLESON ST JOSEPH MANOR | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742913931 | REHABILITATION | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1401 SOUTH GRAND AVENUE | LOS ANGELES | CA | 90015 | 954000909 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| CARRINGTON HEALTH CENTER | |||||||||||
| 800 N 4TH ST | CARRINGTON | ND | 58421 | 450227311 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES - COLORADO | |||||||||||
| 9100 EAST MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840405257 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES - IOWA CORP | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420680448 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION | |||||||||||
| 9100 EAST MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840902211 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION | |||||||||||
| 1150 KELLY JOHNSON BLVD 204 | COLORADO SPRINGS | CO | 80920 | 270930004 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 460992796 | TELEHEALTH | CO | 501(C)(3) | LINE 12A, I | CHI NS | 0 | |
| CENTENNIAL MEDICAL GROUP INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 263946191 | SURGERY CENTER | OR | 501(C)(3) | LINE 10 | MMC - ROSEBURG | 0 | |
| CENTRAL CALIFORNIA HEALTH CENTERS | |||||||||||
| 300 OLD RIVER ROAD STE 200 | BAKERSFIELD | CA | 93311 | 844171789 | CLINIC | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| CENTRAL KANSAS MEDICAL CENTER | |||||||||||
| 3515 BROADWAY | GREAT BEND | KS | 67530 | 480543724 | INACTIVE | KS | 501(C)(3) | LINE 3 | CSH | 0 | |
| CHI HEALTH CONNECT AT HOME - FARGO | |||||||||||
| 4816 AMBER VALLEY PKWY S | FARGO | ND | 58104 | 271966847 | SENIOR LIVING | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| CHI HEALTH FOUNDATION | |||||||||||
| 12809 W DODGE RD | OMAHA | NE | 68154 | 470648586 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | ACH | 0 | |
| CHI KENTUCKY INC | |||||||||||
| 3900 OLYMPIC BLVD STE 400 | ERLANGER | KY | 41018 | 202741651 | INVESTMENTS | KY | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI LIVING COMMUNITIES | |||||||||||
| 5942 RENAISSANCE PLACE STE A | TOLEDO | OH | 43623 | 341892096 | SENIOR LIVING | OH | 501(C)(3) | LINE 12A, I | SFH-OH | 0 | |
| CHI MEMORIAL HOSPITAL - GEORGIA | |||||||||||
| 100 GROSS CRESCENT CIRCLE | FORT OGLETHORPE | GA | 30742 | 822748395 | HOSPITAL | GA | 501(C)(3) | LINE 3 | MHCS | 0 | |
| CHI NATIONAL HOME CARE | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 451261716 | HOME HEALTH | CO | 501(C)(3) | LINE 10 | CHI NS | 0 | |
| CHI NATIONAL SERVICES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 452532084 | HOLDING CO | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI NEBRASKA | |||||||||||
| 12809 WEST DODGE ROAD | OMAHA | NE | 68510 | 363233121 | HOLDING CO | NE | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST JOSEPH CHILDREN'S HEALTH | |||||||||||
| 1929 LINCOLN HWY E STE 150 | LANCASTER | PA | 17602 | 232342997 | HEALTHCARE | PA | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST JOSEPH'S CHILDREN | |||||||||||
| 1516 5TH ST NW | ALBUQUERQUE | NM | 87102 | 710897107 | COMMUNITY | NM | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| CHI ST VINCENT HOSPITAL HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 710236913 | HOSPITAL | AR | 501(C)(3) | LINE 3 | CHISVHS | 0 | |
| CHI ST VINCENT HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 261125064 | HOLDING CO | AR | 501(C)(3) | LINE 12A, I | SVIMC | 0 | |
| CHI ST VINCENT MEDICAL GROUP HOT SPRINGS | |||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 261125131 | PHYSICIANS | AR | 501(C)(3) | LINE 3 | CHISVHS | 0 | |
| COMMONSPIRIT HEALTH | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470617373 | HEALTHCARE | CO | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| COMMONSPIRIT HEALTH FOUNDATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 853374038 | FUNDRAISING FOUNDATION | CO | 501(C)(3) | LINE 7 | CSH | 0 | |
| COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 850919176 | OPERATING INVESTMENTS | DE | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| COMMONSPIRIT HEALTH RESEARCH INSTITUTE | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 271050565 | RESEARCH | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| COMMUNITY HOSPITAL OF SAN BERNARDINO | |||||||||||
| 1805 MEDICAL CENTER DRIVE | SAN BERNARDINO | CA | 92411 | 951643373 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| COMMUNITY LIMITED CARE DIALYSIS CENTER | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 237419853 | HOLDING CO | OH | 501(C)(4) | GSH | 0 | ||
| COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION | |||||||||||
| 631 N 8TH ST | MISSOURI VALLEY | IA | 51555 | 421294399 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AH-CMHMV | 0 | |
| CONTINUING CARE HOSPITAL | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611400619 | HOSPITAL | KY | 501(C)(3) | LINE 3 | SJHS | 0 | |
| DIGNITY COMMUNITY CARE | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 815009488 | HOSPITAL | CO | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 941196203 | HOSPITAL | CA | 501(C)(3) | LINE 3 | CSH | 0 | |
| DIGNITY HEALTH CONNECTED LIVING | |||||||||||
| 200 MERCY OAKS DRIVE | REDDING | CA | 96003 | 237115371 | SENIOR CENTER SERVICES | CA | 501(C)(3) | LINE 7 | DH | 0 | |
| DIGNITY HEALTH FOUNDATION | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 462037641 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH FOUNDATION - INLAND EMPIRE | |||||||||||
| 2101 N WATERMAN AVENUE | SAN BERNARDINO | CA | 92404 | 237440086 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH FOUNDATION EAST VALLEY | |||||||||||
| 475 SOUTH DOBSON ROAD | CHANDLER | AZ | 85224 | 742418514 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH HPL SELF-INSURANCE TRUST | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 943006034 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH INSURANCE NEVADA LTD | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 813800752 | SELF INSURANCE | NV | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DIGNITY HEALTH MEDICAL FOUNDATION | |||||||||||
| 3400 DATA DRIVE | RANCHO CORDOVA | CA | 95670 | 680220314 | MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| DIGNITY HEALTH WORKERS COMP SELF-INSURANCE TRUST | |||||||||||
| 185 BERRY STREET STE 200 | SAN FRANCISCO | CA | 94107 | 946612446 | SELF INSURANCE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN HEALTH SERVICES | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770056778 | COMMUNITY HEALTH SYSTEM | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN HOSPITAL FOUNDATION | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 942450442 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| DOMINICAN OAKS CORPORATION | |||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770127719 | OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS | CA | 501(C)(3) | LINE 10 | DHS | 0 | |
| EAST TEXAS CLINICAL SERVICES | |||||||||||
| 2801 VIA FORTUNA SUITE 500 | AUSTIN | TX | 78746 | 454736213 | HEALTHCARE | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ENUMCLAW REGIONAL HOSPITAL ASSOCIATION | |||||||||||
| 1455 BATTERSBY AVE | ENUMCLAW | WA | 98022 | 910715805 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| FLAGET HEALTHCARE INC | |||||||||||
| 4305 NEW SHEPHERDSVILLE RD | BARDSTOWN | KY | 40004 | 611345363 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| FLAGET MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 4305 NEW SHEPHERDSVILLE RD | BARDSTOWN | KY | 40004 | 562351341 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | FH | 0 | |
| FRANCISCAN CARE CENTER | |||||||||||
| 4111 N HOLLAND-SYLVANIA RD | TOLEDO | OH | 43623 | 341931806 | HEALTHCARE | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| FRANCISCAN FOUNDATION | |||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911145592 | FUNDRAISING FOUNDATION | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRANCISCAN HEALTH SYSTEM | |||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 910564491 | HOSPITAL | WA | 501(C)(3) | LINE 3 | CSH | 0 | |
| FRANCISCAN HEALTH VENTURES | |||||||||||
| TACOMA FNC CTR BLDG 1145 BROADWAY | TACOMA | WA | 98402 | 431882377 | INACTIVE | MO | 501(C)(3) | LINE 10 | CSH | 0 | |
| FRANCISCAN MEDICAL GROUP | |||||||||||
| 1313 BROADWAY STE 200 | TACOMA | WA | 98402 | 911939739 | PHYSICIANS | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| FRANCISCAN VILLA OF SOUTH MILWAUKEE INC | |||||||||||
| 3601 S CHICAGO AVE | SOUTH MILWAUKEE | WI | 53172 | 391093829 | INACTIVE | WI | 501(C)(3) | LINE 10 | CSH | 0 | |
| FRENCH HOSPITAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1911 JOHNSON AVENUE | SAN LUIS OBISPO | CA | 93401 | 203256125 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| GARRISON MEMORIAL HOSPITAL | |||||||||||
| 407 THIRD AVENUE SOUTHEAST | GARRISON | ND | 58540 | 450227752 | HOSPITAL | ND | 501(C)(3) | LINE 3 | SAMC | 0 | |
| GLENDALE MEMORIAL HEALTH FOUNDATION | |||||||||||
| 1420 SOUTH CENTRAL AVENUE | GLENDALE | CA | 91204 | 953625651 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| GLOBAL HEALTH INITIATIVES | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 201536108 | INACTIVE | CO | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 311778403 | EDUCATION | OH | 501(C)(3) | LINE 2 | GSH | 0 | |
| GOOD SAMARITAN FOUNDATION OF CINCINNATI INC | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 311206047 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | GSH | 0 | |
| GOOD SAMARITAN HOSPITAL | |||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470379755 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||||||||
| 111 W 31ST ST | KEARNEY | NE | 68847 | 470659443 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | GSH-KN | 0 | |
| HARRISON MEDICAL CENTER | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 910565546 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HARRISON MEDICAL CENTER FOUNDATION | |||||||||||
| 2520 CHERRY AVE | BREMERTON | WA | 98310 | 911197626 | FUNDRAISING FOUNDATION | WA | 501(C)(3) | LINE 7 | HMC | 0 | |
| HEALTHCARE AND WELLNESS FOUNDATION | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 760761782 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | LINE 12A, I | SFMC-MN | 0 | |
| HIGHLINE MEDICAL CENTER | |||||||||||
| 16251 SYLVESTER RD SW | BURIEN | WA | 98166 | 910712166 | HOSPITAL | WA | 501(C)(3) | LINE 3 | FHS | 0 | |
| HOUSE OF MERCY | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421323808 | ASSIST LIVING | IA | 501(C)(3) | LINE 7 | CHI-IA CORP | 0 | |
| JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611029768 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| KENTUCKYONE HEALTH MEDICAL GROUP INC | |||||||||||
| 100 E LIBERTY ST STE 800 | LOUISVILLE | KY | 40202 | 611352729 | PHYSICIANS | KY | 501(C)(3) | LINE 10 | JHSMH | 0 | |
| KENTUCKYONE HEALTH INC | |||||||||||
| ONE SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 611029769 | HEALTHCARE | KY | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| LAKEWOOD HEALTH CENTER | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 410758434 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| LAKEWOOD REGIONAL HEALTHCARE FOUNDATION | |||||||||||
| 600 MAIN AVE S | BAUDETTE | MN | 56623 | 411893795 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | LHC | 0 | |
| LEGACY FOUNDATION OF KENTUCKIANA INC | |||||||||||
| 1451 HARRODSBURG RD STE D-308 | LEXINGTON | KY | 40504 | 832170324 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | KOH | 0 | |
| LISBON AREA HEALTH SERVICES | |||||||||||
| 905 MAIN ST | LISBON | ND | 58054 | 820558836 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| LUFKIN VISION ACQUISITIONS | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75901 | 820563768 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MADISON ST JOSEPH HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742761145 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| MADONNA MANOR INC | |||||||||||
| 2344 AMSTERDAM ROAD | VILLA HILLS | KY | 51017 | 610654635 | ASSIST LIVING | KY | 501(C)(3) | LINE 10 | CHILC | 0 | |
| MARIAN REGIONAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 953818027 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MARK TWAIN MEDICAL CENTER | |||||||||||
| 768 MOUNTAIN RANCH ROAD | SAN ANDREAS | CA | 95249 | 680127677 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC | |||||||||||
| 2525 DE SALES AVE | CHATTANOOGA | TN | 37404 | 621839548 | FUNDRAISING FOUNDATION | TN | 501(C)(3) | LINE 7 | MHCS | 0 | |
| MEMORIAL HEALTH CARE SYSTEM INC | |||||||||||
| 2525 DE SALES AVE | CHATTANOOGA | TN | 37404 | 620532345 | HOSPITAL | TN | 501(C)(3) | LINE 3 | CSH | 0 | |
| MEMORIAL HEALTH PARTNERS FOUNDATION INC | |||||||||||
| 5600 BRAINERD RD STE 500 | CHATTANOOGA | TN | 37411 | 030417049 | HEALTHCARE | TN | 501(C)(3) | LINE 10 | MHCS | 0 | |
| MEMORIAL HEALTH SYSTEM OF EAST TEXAS | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 750755367 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| MEMORIAL MEDICAL CENTER - LIVINGSTON | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 760436439 | HOSPITAL | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MEMORIAL MEDICAL CENTER - SAN AUGUSTINE | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752663904 | HOSPITAL | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MEMORIAL MULTISPECIALTY ASSOCIATES | |||||||||||
| 1201 FRANK AVE | LUFKIN | TX | 95904 | 752721155 | PHYSICIANS | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| MEMORIAL SPECIALTY HOSPITAL | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 95902 | 752492741 | INACTIVE | TX | 501(C)(3) | LINE 3 | MHSET | 0 | |
| MERCY AUXILIARY OF CENTRAL IOWA | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 426076069 | AUXILIARY | IA | 501(C)(3) | LINE 12A, I | MF-DM IA | 0 | |
| MERCY CLINICS INC | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421193699 | PHYSICIANS | IA | 501(C)(3) | LINE 10 | CHI-IA CORP | 0 | |
| MERCY COLLEGE OF HEALTH SCIENCES | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421511682 | EDUCATION | IA | 501(C)(3) | LINE 2 | CHI-IA CORP | 0 | |
| MERCY FOUNDATION BAKERSFIELD | |||||||||||
| PO BOX 119 | BAKERSFIELD | CA | 93302 | 770201321 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MERCY FOUNDATION OF DES MOINES IA | |||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 237358794 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 7 | CHI-IA CORP | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 936088946 | FUNDRAISING FOUNDATION | OR | 501(C)(3) | LINE 7 | MMC - ROSEBURG | 0 | |
| MERCY HEALTH CARE FOUNDATION | |||||||||||
| PO BOX 368 | CORNING | IA | 50841 | 421461064 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AHMH-CORNING | 0 | |
| MERCY HEALTHCARE FOUNDATION | |||||||||||
| 570 CHAUTAUQUA BLVD | VALLEY CITY | ND | 58072 | 450435338 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | MHVC | 0 | |
| MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS | |||||||||||
| 800 MERCY DR | COUNCIL BLUFFS | IA | 51503 | 421178204 | FUNDRAISING FOUNDATION | IA | 501(C)(3) | LINE 12A, I | AHBMHS | 0 | |
| MERCY HOSPITAL OF DEVILS LAKE | |||||||||||
| 1031 7TH ST NE | DEVILS LAKE | ND | 58301 | 450227012 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY HOSPITAL OF DEVILS LAKE FOUNDATION | |||||||||||
| 1031 7TH ST NE | DEVILS LAKE | ND | 58301 | 352367360 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 7 | MHDL | Yes (1) | |
| MERCY HOSPITAL OF VALLEY CITY | |||||||||||
| 570 CHAUTAUQUA BLVD | VALLEY CITY | ND | 58072 | 450226553 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MCMAHON TERRACE | |||||||||||
| 3865 J STREET | SACRAMENTO | CA | 95816 | 680117340 | SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES | CA | 501(C)(3) | LINE 10 | DH | 0 | |
| MERCY MEDICAL CENTER | |||||||||||
| 1301 15TH AVE WEST | WILLISTON | ND | 58801 | 450231183 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MEDICAL CENTER - CENTERVILLE | |||||||||||
| ONE ST JOSEPHS DRIVE | CENTERVILLE | IA | 52544 | 420680308 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI-IA CORP | 0 | |
| MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER | |||||||||||
| 204 N 4TH AVE E | NEWTON | IA | 50314 | 421470935 | HOSPITAL | IA | 501(C)(3) | LINE 3 | CHI-IA CORP | 0 | |
| MERCY MEDICAL CENTER MERCED FOUNDATION | |||||||||||
| 301 E 13TH STREET | MERCED | CA | 95340 | 770035928 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| MERCY MEDICAL CENTER INC | |||||||||||
| 2700 STEWART PKWY | ROSEBURG | OR | 97471 | 930386868 | HOSPITAL | OR | 501(C)(3) | LINE 3 | CSH | 0 | |
| MERCY MEDICAL FOUNDATION | |||||||||||
| 1301 15TH AVE WEST | WILLISTON | ND | 58801 | 450381803 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | MMC WILLISTON | 0 | |
| NEBRASKA HEART HOSPITAL | |||||||||||
| 7500 S 91ST ST | LINCOLN | NE | 68526 | 392031968 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| NORTHLAND HEALTHCARE ALLIANCE | |||||||||||
| 2223 EAST ROSSER AVENUE | BISMARCK | ND | 58501 | 911845296 | MANAGEMENT | ND | 501(C)(3) | LINE 7 | SAMC | 0 | |
| NORTHRIDGE HOSPITAL FOUNDATION | |||||||||||
| 18300 ROSCOE BLVD | NORTHRIDGE | CA | 91328 | 237444901 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DCC | 0 | |
| OAKES COMMUNITY HOSPITAL | |||||||||||
| 1200 N 7TH ST | OAKES | ND | 58474 | 450231675 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| OAKES COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| 1200 N 7TH ST | OAKES | ND | 58474 | 710966606 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | OCH | 0 | |
| PACIFIC CENTRAL COAST HEALTH CENTERS | |||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770447575 | CLINIC | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| PINEYWOODS MEDICAL DEVELOPMENT CORP | |||||||||||
| PO BOX 1447 | LUFKIN | TX | 75902 | 752493116 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | MHSET | 0 | |
| PORT CITY OPERATING COMPANY LLC | |||||||||||
| 3400 DATA DRIVE | RANCHO CORDOVA | CA | 95670 | 465322209 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DH | 0 | |
| PROVIDENCE CARE CENTER | |||||||||||
| 2025 HAYES AVENUE | SANDUSKY | OH | 44870 | 341658625 | LTERM CARE | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION | |||||||||||
| 5055 PROVIDENCE DRIVE | SANDUSKY | OH | 44870 | 341896807 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| PUEBLO STEPUP | |||||||||||
| 1925 E ORMAN AVE STE G52 | PUEBLO | CO | 81004 | 841234295 | COMMUNITY | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| SET OF COLORADO SPRINGS INC | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 841183335 | SENIOR CENTER SERVICES | CO | 501(C)(3) | LINE 7 | CHIC | 0 | |
| SAINT CLARE'S COMMUNITY CARE INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222876836 | INACTIVE | NJ | 501(C)(3) | LINE 10 | SCHS | 0 | |
| SAINT CLARE'S HEALTH SERVICES INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 223639733 | INACTIVE | NJ | 501(C)(3) | LINE 10 | CSH | 0 | |
| SAINT CLARE'S HOSPITAL INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 223319886 | INACTIVE | NJ | 501(C)(3) | LINE 3 | SCHS | 0 | |
| SAINT ELIZABETH FOUNDATION | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 470625523 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SERMC | 0 | |
| SAINT ELIZABETH HEALTH SERVICES | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 363233120 | INACTIVE | NE | 501(C)(3) | LINE 3 | SERMC | 0 | |
| SAINT ELIZABETH REGIONAL MEDICAL CENTER | |||||||||||
| 555 S 70TH ST | LINCOLN | NE | 68510 | 470379836 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| SAINT FRANCIS MEDICAL CENTER | |||||||||||
| 2620 W FAIDLEY | GRAND ISLAND | NE | 68803 | 470376601 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| SAINT FRANCIS MEDICAL CENTER FOUNDATION | |||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 470630267 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SFMC-NE | 0 | |
| SAINT FRANCIS MEMORIAL HOSPITAL | |||||||||||
| 900 HYDE STREET | SAN FRANCISCO | CA | 94109 | 941156295 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC | |||||||||||
| 305 ESTILL ST | BEREA | KY | 40403 | 260152877 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH HEALTH SYSTEM INC | |||||||||||
| ONE ST JOSEPHS DRIVE | LEXINGTON | KY | 40504 | 611334601 | HOSPITAL | KY | 501(C)(3) | LINE 3 | KOH | 0 | |
| SAINT JOSEPH HOSPITAL FOUNDATION INC | |||||||||||
| 701 BOB OLINK DR 200 | LEXINGTON | KY | 40504 | 611159649 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 12A, I | SJHS | 0 | |
| SAINT JOSEPH LONDON FOUNDATION INC | |||||||||||
| 1001 SAINT JOSEPH LANE | LONDON | KY | 40741 | 260438748 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH MOUNT STERLING FOUNDATION INC | |||||||||||
| 225 FALCON DR | MOUNT STERLING | KY | 40353 | 272884584 | FUNDRAISING FOUNDATION | KY | 501(C)(3) | LINE 7 | SJHS | 0 | |
| SAINT JOSEPH'S HOSPITAL FOUNDATION | |||||||||||
| 2500 FAIRWAY STREET | DICKINSON | ND | 58601 | 363418207 | FUNDRAISING FOUNDATION | ND | 501(C)(3) | LINE 12A, I | SJHHC | 0 | |
| SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION | |||||||||||
| 438 WEST LAS TUNAS DRIVE | SAN GABRIEL | CA | 91776 | 953430341 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 104 W 17TH ST | SCHUYLER | NE | 68661 | 363630014 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 12A, I | AHMHS | 0 | |
| SIERRA NEVADA MEMORIAL-MINERS HOSPITAL | |||||||||||
| 155 GLASSON WAY | GRASS VALLEY | CA | 95945 | 941439787 | HOSPITAL | CA | 501(C)(3) | LINE 3 | DCC | 0 | |
| SJRMC JOPLIN MISSOURI | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 440545809 | HOSPITAL | MO | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST FRANCIS FOUNDATION OF SANTA BARBARA | |||||||||||
| 2323 DE LA VINA ST SUITE 104 | SANTA BARBARA | CA | 93105 | 237137119 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST FRANCIS HOSPITAL SUPPORT CORPORATION | |||||||||||
| 601 E MICHELTORENA STREET | SANTA BARBARA | CA | 93103 | 770022302 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOHNS HEALTHCARE FOUNDATION | |||||||||||
| 1600 NORTH ROSE AVENUE | OXNARD | CA | 93030 | 202865781 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOSEPHS FOUNDATION (PHOENIX) | |||||||||||
| 350 WEST THOMAS ROAD | PHOENIX | AZ | 85013 | 942941245 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST JOSEPHS FOUNDATION OF SAN JOAQUIN | |||||||||||
| 1800 N CALIFORNIA STREET | STOCKTON | CA | 95204 | 510432777 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARY MEDICAL CENTER FOUNDATION | |||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 237153876 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARY PROFESSIONAL BUILDING INC | |||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 237373088 | INACTIVE | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST MARYS MEDICAL CENTER FOUNDATION | |||||||||||
| 450 STANYAN STREET | SAN FRANCISCO | CA | 94117 | 943336143 | FUNDRAISING FOUNDATION | CA | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST ROSE DOMINICAN HEALTH FOUNDATION | |||||||||||
| 3001 ST ROSE PARKWAY | HENDERSON | NV | 89052 | 880349432 | FUNDRAISING FOUNDATION | NV | 501(C)(3) | LINE 12A, I | DH | 0 | |
| ST ALEXIUS MEDICAL CENTER | |||||||||||
| 900 EAST BROADWAY AVENUE | BISMARCK | ND | 58501 | 450226711 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST ANNE OC | |||||||||||
| 1145 BROADWAY PLAZA STE 1200 | TACOMA | WA | 98402 | 863590968 | INACTIVE | WA | 501(C)(3) | LINE 10 | FHS | 0 | |
| ST ANTHONY HOSPITAL | |||||||||||
| 2801 ST ANTHONY WAY | PENDLETON | OR | 97801 | 930391614 | HOSPITAL | OR | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST ANTHONY HOSPITAL FOUNDATION | |||||||||||
| 2801 ST ANTHONY WAY | PENDLETON | OR | 97801 | 930992727 | FUNDRAISING FOUNDATION | OR | 501(C)(3) | LINE 12A, I | SAH | 0 | |
| ST ANTHONY'S HOSPITAL ASSOCIATION | |||||||||||
| FOUR HOSPITAL DR | MORRILTON | AR | 72110 | 710245507 | HOSPITAL | AR | 501(C)(3) | LINE 3 | SVIMC | 0 | |
| ST CATHERINE HOSPITAL | |||||||||||
| 401 EAST SPRUCE ST | GARDEN CITY | KS | 67846 | 480543721 | HOSPITAL | KS | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION | |||||||||||
| 401 EAST SPRUCE ST | GARDEN CITY | KS | 67846 | 200598702 | FUNDRAISING FOUNDATION | KS | 501(C)(3) | LINE 12A, I | SCH | 0 | |
| ST CLARE COMMONS | |||||||||||
| 12469 FIVE POINT ROAD | TOLEDO | OH | 43551 | 270163752 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| ST DOMINIC OF ONTARIO OREGON | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 930433692 | INVESTMENTS | OR | 501(C)(4) | CSH | 0 | ||
| ST FRANCIS HOME | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 410729978 | LTERM CARE | MN | 501(C)(3) | LINE 10 | CSH | 0 | |
| ST FRANCIS LIFE CARE CORPORATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222536017 | INACTIVE | NJ | 501(C)(3) | LINE 8 | SCHS | 0 | |
| ST FRANCIS MEDICAL CENTER | |||||||||||
| 2400 ST FRANCIS DR | BRECKENRIDGE | MN | 56520 | 410695598 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH FOUNDATION OF BRYAN TEXAS | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742351158 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 12A, I | SJSC | 0 | |
| ST JOSEPH MANOR | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742847594 | LTERM CARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| ST JOSEPH MEDICAL CENTER INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 520591461 | INACTIVE | MD | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH PHYSICIAN ASSOCIATES | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 203159302 | PHYSICIANS | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH PHYSICIAN ENTERPRISE INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 521311775 | INACTIVE | MD | 501(C)(3) | LINE 12A, I | SJMC | 0 | |
| ST JOSEPH REGIONAL HEALTH CENTER | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 741282696 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH REGIONAL HEALTH PARTNERS | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 454088170 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SJSC | 0 | |
| ST JOSEPH REGIONAL HEALTH PARTNERS ACO | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 463265423 | HEALTHCARE | TX | 501(C)(3) | LINE 10 | SJSC | 0 | |
| ST JOSEPH SERVICES CORPORATION | |||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742455161 | MANAGEMENT | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ST JOSEPH'S AREA HEALTH SERVICES | |||||||||||
| 600 PLEASANT AVE | PARK RAPIDS | MN | 56470 | 410695603 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST JOSEPH'S HOSPITAL AND HEALTH CENTER | |||||||||||
| 2500 FAIRWAY ST | DICKINSON | ND | 58601 | 450226429 | HOSPITAL | ND | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST LEONARD | |||||||||||
| 8100 CLYO ROAD | CENTERVILLE | OH | 45458 | 341940863 | LIVING COMM | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 273733278 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 261947374 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 260335902 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S COMMUNITY HEALTH SERVICES | |||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 760536234 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S FOUNDATION | |||||||||||
| 1213 HERMANN DRIVE STE 855 | HOUSTON | TX | 77004 | 453811485 | FUNDRAISING FOUNDATION | TX | 501(C)(3) | LINE 7 | SLHS | 0 | |
| ST LUKE'S HEALTH SYSTEM CORPORATION | |||||||||||
| PO BOX 20269 | HOUSTON | TX | 77225 | 760536232 | MANAGEMENT | TX | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| ST LUKE'S HOSPITAL AT THE VINTAGE | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 263734606 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| ST LUKE'S PROPERTIES CORPORATION | |||||||||||
| 1213 HERMANN DRIVE STE 855 | HOUSTON | TX | 77004 | 760531716 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | SLHS | 0 | |
| ST LUKE'S SUGAR LAND PROPERTIES CORPORATION | |||||||||||
| 6624 FANNIN ST STE 2505 | HOUSTON | TX | 77030 | 454120549 | PROPERTY MGMT | TX | 501(C)(3) | LINE 12A, I | SLCDC-SL | 0 | |
| ST MARY'S COMMUNITY HOSPITAL | |||||||||||
| 1301 GRUNDMAN BOULEVARD | NEBRASKA CITY | NE | 68410 | 470443636 | HOSPITAL | NE | 501(C)(3) | LINE 3 | CHI NEBRASKA | 0 | |
| ST MARY'S HOSPITAL FOUNDATION | |||||||||||
| 1314 3RD AVE | NEBRASKA CITY | NE | 68410 | 470707604 | FUNDRAISING FOUNDATION | NE | 501(C)(3) | LINE 7 | SMCH | 0 | |
| ST VINCENT FOUNDATION | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 510169537 | FUNDRAISING FOUNDATION | AR | 501(C)(3) | LINE 12A, I | SVIMC | 0 | |
| ST VINCENT INFIRMARY MEDICAL CENTER | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710236917 | HOSPITAL | AR | 501(C)(3) | LINE 3 | CSH | 0 | |
| ST VINCENT MEDICAL GROUP | |||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710830696 | PHYSICIANS | AR | 501(C)(3) | LINE 10 | SVIMC | 0 | |
| SYLVANIA FRANCISCAN HEALTH | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 341412964 | HOLDING CO | OH | 501(C)(3) | LINE 12A, I | CSH | 0 | |
| SYLVANIA FRANCISCAN HEALTH FOUNDATION | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 455357161 | INACTIVE | OH | 501(C)(3) | LINE 12A, I | SFH-OH | 0 | |
| THE COMMONS OF PROVIDENCE | |||||||||||
| 5000 PROVIDENCE DRIVE | SANDUSKY | OH | 44870 | 341826097 | ASSIST LIVING | OH | 501(C)(3) | LINE 10 | CHILC | 0 | |
| THE COMMUNITY HOSPITAL OF BRAZOSPORT | |||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 741385192 | HOSPITAL | TX | 501(C)(3) | LINE 3 | SLHS | 0 | |
| THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH | |||||||||||
| 625 EDEN PARK DRIVE 7TH FLOOR | CINCINNATI | OH | 45202 | 310537486 | HOSPITAL | OH | 501(C)(3) | LINE 3 | CSH | 0 | |
| THE PHYSICIAN NETWORK | |||||||||||
| 2000 Q ST STE 500 | LINCOLN | NE | 68503 | 470780857 | PHYSICIANS | NE | 501(C)(3) | LINE 12A, I | CHI NEBRASKA | 0 | |
| TOTAL HEALTHCARE | |||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840927232 | INACTIVE | CO | 501(C)(3) | LINE 3 | CHIC | 0 | |
| TRINITY HEALTH FOUNDATION | |||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 311329423 | FUNDRAISING FOUNDATION | OH | 501(C)(3) | LINE 12A, I | THS | 0 | |
| TRINITY HEALTH SYSTEM | |||||||||||
| 380 SUMMIT AVENUE | STEUBENVILLE | OH | 43952 | 341818681 | HEALTHCARE | OH | 501(C)(3) | LINE 12A, I | 0 | N/A | |
| TRINITY HOSPITAL TWIN CITY | |||||||||||
| 819 NORTH FIRST STREET | DENNISON | OH | 44621 | 275401105 | HOSPITAL | OH | 501(C)(3) | LINE 3 | THS | 0 | |
| TRI-STATE HEALTH SERVICES INC | |||||||||||
| ONE ROSS PARK BLVD | STEUBENVILLE | OH | 43952 | 341522484 | ASSIST LIVING | OH | 501(C)(3) | LINE 7 | THS | 0 | |
| UNITY FAMILY HEALTHCARE | |||||||||||
| 815 SE 2ND ST | LITTLE FALLS | MN | 56345 | 410721642 | HOSPITAL | MN | 501(C)(3) | LINE 3 | CSH | 0 | |
| VILLA NAZARETH INC | |||||||||||
| 801 PAGE DR | FARGO | ND | 58103 | 450226714 | LTERM CARE | ND | 501(C)(3) | LINE 10 | CSH | 0 | |
| VISITING NURSE ASSOCIATION OF ST CLARE'S INC | |||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 221768334 | INACTIVE | NJ | 501(C)(3) | LINE 10 | SCHS | 0 | |
| YAVAPAI COMMUNITY HOSPITAL ASSOC | |||||||||||
| 1003 WILLO CREEK ROAD | PRESCOTT | AZ | 86301 | 860098923 | HOSPITAL | AZ | 501(C)(3) | LINE 3 | DCC | 0 | |
| YAVAPAI REGIONAL MEDICAL CENTER FOUNDATION | |||||||||||
| 1003 WILLO CREEK ROAD | PRESCOTT | AZ | 86301 | 861038463 | FUNDRAISING FOUNDATION | AZ | 501(C)(3) | LINE 12A, I | YRMC | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (83 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Share Of Total IncomeShareOfTotalIncomeAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN MERCY HOME CARE LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 830486150 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||
| ARIZONA CARE NETWORK - NEXT LLC | |||||||||||||||
| 4222 E THOMAS RD STE 400 | PHOENIX | AZ | 85018 | 474696671 | CARE NETWORK | AZ | N/A | N/A | 0 | 0 | |||||
| ARIZONA CARE NETWORK LLC (ACN LLC) | |||||||||||||||
| 4222 E THOMAS RD STE 400 | PHOENIX | AZ | 85013 | 454494682 | CARE NETWORK | AZ | N/A | N/A | 0 | 0 | |||||
| ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC | |||||||||||||||
| 1510 COTNER AVENUE | LOS ANGELES | CA | 90025 | 851067265 | DIAGNOSTIC SERVICES | CA | N/A | N/A | 0 | 0 | |||||
| AUDUBON LAND COMPANY LLC | |||||||||||||||
| 630 SOUTHPOINTE COURT 200 | COLORADO SPRINGS | CO | 80906 | 841513085 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||
| BAYLOR CHI ST LUKES HEALTH SERVICES LLC | |||||||||||||||
| 6624 FANNIN ST STE 1100 | HOUSTON | TX | 77030 | 472079184 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | |||||
| BERGAN MERCY SURGERY CENTER LLC | |||||||||||||||
| 7710 MERCY RD STE 200 | OMAHA | NE | 68124 | 208671994 | AMBUL SURG CTR | NE | N/A | N/A | 0 | 0 | |||||
| BERYWOOD OFFICE PROPERTIES LLC | |||||||||||||||
| 2501 CITICO AVENUE | CHATTANOGA | TN | 37404 | 621875199 | PHYS OFFICE | TN | N/A | N/A | 0 | 0 | |||||
| BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD | |||||||||||||||
| HEALTH SERVICES | N/A | N/A | 0 | 0 | 709 WING ON PLAZA 62 MODY ROAD TS | HONG KONG | CH | CH | |||||||
| BLUEGRASS REGIONAL IMAGING CENTER | |||||||||||||||
| 1218 SOUTH BROADWAY STE 310 | LEXINGTON | KY | 40504 | 611386736 | DIAGNOSTIC IMAGING | KY | N/A | N/A | 0 | 0 | |||||
| CBCC OUTSMARTING CANCER LLC | |||||||||||||||
| 6501 TRUXTUN AVENUE | BAKERSFIELD | CA | 93309 | 461602286 | RADIATION / ONCOLOGY | CA | N/A | N/A | 0 | 0 | |||||
| CENTRAL NEBRASKA REHAB SVCS LLC | |||||||||||||||
| 3004 W FAIDLEY AVENUE | GRAND ISLAND | NE | 68803 | 810653461 | PHYSICAL THERAPY | NE | N/A | N/A | 0 | 0 | |||||
| CENTURA-SCA HOLDINGS LLC | |||||||||||||||
| 569 BROOK VILLAGE STE 901 | BIRMINGHAM | AL | 35209 | 474823023 | OP SURGERY CENTER | AL | N/A | N/A | 0 | 0 | |||||
| CHI OPERATING INVESTMENT PROGRAM LP | |||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 470727942 | INVESTMENTS | CO | N/A | EXCLUDED | 0 | 0 | $2,973,712 | ||||
| CHICAMSURG SURGERY CENTERS LLC | |||||||||||||||
| 1A BURTON HILLS BLVD | NASHVILLE | TN | 37215 | 465683027 | SURGERY CENTER | CO | N/A | N/A | 0 | 0 | |||||
| COLORADO SPRINGS CK LEASING LLC | |||||||||||||||
| 630 SOUTHPOINTE COURT 200 | COLORADO SPRINGS | CO | 80906 | 262982714 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||
| COMMUNITY MERCY HOME CARE SERVICES OF SPRINGFIELD LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311746556 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||
| DE JV LLC | |||||||||||||||
| 8686 NEW TRAILS DRIVE | THE WOODLANDS | TX | 77381 | 320496548 | EMERGENCY CARE | NV | N/A | N/A | 0 | 0 | |||||
| DHHP SURGERY CENTERS LLC | |||||||||||||||
| 1513 S GRAND AVENUE STE 350 | LOS ANGELES | CA | 90015 | 831847466 | SURGERY | DE | N/A | N/A | 0 | 0 | |||||
| DHRT HOLDINGS LLC | |||||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 352484591 | HOLDING COMPANY | DE | N/A | N/A | 0 | 0 | |||||
| DIGNITY- GOHEALTHURGENT CARE MGMT LLC | |||||||||||||||
| 5555 GLENRIDGE CONNECTOR STE 700 | ATLANTA | GA | 30342 | 352548698 | MANAGEMENT SERVICES | DE | N/A | N/A | 0 | 0 | |||||
| DIGNITY HEALTH AT HOME LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 824674115 | HEALTHCARE SRVC | DE | N/A | N/A | 0 | 0 | |||||
| DIGNITY HEALTH SPECIALTY PHARMACY LLC | |||||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 320589462 | SPECIALTY PHARMACY SERVICES | DE | N/A | N/A | 0 | 0 | |||||
| DIGNITY HOME RECOVERY CARE LLC | |||||||||||||||
| 49 MUSIC SQUARE WEST SUITE 401 | NASHVILLE | TN | 37203 | 832832522 | HOME RECOVERY PROGRAM | DE | N/A | N/A | 0 | 0 | |||||
| DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC | |||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 202999237 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||
| DIGNITYUSP NORCAL SURGERY CENTERS LLC | |||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 202468509 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||
| DIGNITYUSP PHOENIX SURGERY CENTERS LLC | |||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 134248908 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||
| DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC | |||||||||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 352584991 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||
| DIGNITY-ABRAZO HEALTH NETWORK LLC | |||||||||||||||
| 4222 E THOMAS RD STE 400 | PHOENIX | AZ | 85018 | 465477985 | MANAGEMENT SERVICES | AZ | N/A | N/A | 0 | 0 | |||||
| DOMINICAN MAGNETIC RESONANCE IMAGING CENTER | |||||||||||||||
| 1545 SOQUEL DRIVE | SANTA CRUZ | CA | 94065 | 770095477 | IMAGING CENTER | CA | N/A | N/A | 0 | 0 | |||||
| ECCS ACQUISITION COMPANY LLC | |||||||||||||||
| 2940 NORTH CIRCLE DRIVE | COLORADO SPRINGS | CO | 80909 | 352656413 | AMBUL SURG CTR | CO | N/A | N/A | 0 | 0 | |||||
| ENDOSCOPY CENTER OF ARKANSAS | |||||||||||||||
| 1024 NORTH UNIVERSITY AVE | LITTLE ROCK | AR | 72207 | 201337002 | DIAGNOSTIC SERVICES | AR | N/A | N/A | 0 | 0 | |||||
| FOLSOM SIERRA ENDOSCOPY CENTER LP | |||||||||||||||
| 1671 CREEKSIDE DRIVE SUITE 100 | FOLSOM | CA | 95630 | 680482416 | ENDOSCOPY | CA | N/A | N/A | 0 | 0 | |||||
| FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC | |||||||||||||||
| 6622 WOLLOCHET DR NW | GIG HARBOR | WA | 98335 | 463494108 | REAL ESTATE | WA | N/A | N/A | 0 | 0 | |||||
| FRANCISCAN SPECIALTY CARE LLC | |||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 813725123 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | |||||
| GOOD SAMARITAN HOME CARE SERVICES OF VINCENNE IN LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 201792869 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||
| HC SL VINTAGE I LLC | |||||||||||||||
| 18000 W SARAH LANE STE 250 | BROOKFIELD | WI | 53045 | 270453767 | PROPERTY HOLDING | WI | N/A | N/A | 0 | 0 | |||||
| HEALTHCARE SUPPORT SERVICES LLC | |||||||||||||||
| PO BOX 9804 | GRAND ISLAND | NE | 68802 | 721546196 | LAUNDRY | NE | N/A | N/A | 0 | 0 | |||||
| HEARTLAND ONCOLOGY LLC | |||||||||||||||
| 2337 E CRAWFORD ST | SALINA | KS | 67401 | 464265403 | ONCOLOGY | KS | N/A | N/A | 0 | 0 | |||||
| LAKESIDE AMBULATORY SURGICAL CENTER LLC | |||||||||||||||
| 17031 LAKESIDE HILLS DR | OMAHA | NE | 68130 | 204267902 | AMBUL SURG CTR | NE | N/A | N/A | 0 | 0 | |||||
| LAKESIDE ENDOSCOPY CENTER LLC | |||||||||||||||
| 17001 LAKESIDE HILLS PLZ STE 201 | OMAHA | NE | 68130 | 205544496 | ENDOSCOPY SRVC | NE | N/A | N/A | 0 | 0 | |||||
| LEXINGTON MBO PARTNERS LTD | |||||||||||||||
| 5050 SOUTH SYRACUSE ST STE 800 | DENVER | CO | 80237 | 651132855 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||
| LINCOLN CK LEASING LLC | |||||||||||||||
| 555 SOUTH 70TH STREET | LINCOLN | NE | 68510 | 262496856 | REAL ESTATE | NE | N/A | N/A | 0 | 0 | |||||
| MEMORIAL MEDICAL PLAZA | |||||||||||||||
| 3838 SAN DIMAS SUITE B 201 | BAKERSFIELD | CA | 93301 | 364510880 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | |||||
| MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC | |||||||||||||||
| 2740 M STREET | MERCED | CA | 95340 | 943358445 | MANAGEMENT OF CANCER CENTER | CA | N/A | N/A | 0 | 0 | |||||
| MERCY REHABILITATION HOSPITAL LLC | |||||||||||||||
| 680 SOUTH FOURTH STREET | LOUISVILLE | KY | 40202 | 814437201 | HEALTHCARE SRVC | TX | N/A | N/A | 0 | 0 | |||||
| MILITARY ROAD PROPERTIES LLC | |||||||||||||||
| 181 S 333RD STREET STE 250 | FEDERAL WAY | WA | 98003 | 912067879 | REAL ESTATE | WA | N/A | N/A | 0 | 0 | |||||
| NEBRASKA SPINE HOSPITAL LLC | |||||||||||||||
| 6901 N 72ND ST STE 20300 | OMAHA | NE | 68122 | 270263191 | SPINE HOSPITAL | NE | N/A | N/A | 0 | 0 | |||||
| NICU OPERATING CO OF SANTA CRUZ LLC | |||||||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 460502935 | NEONATAL HEALTHCARE | CA | N/A | N/A | 0 | 0 | |||||
| NORTH RIVER SURGERY CENTER LLC | |||||||||||||||
| 2209 WILDWOOD AVE | SHERWOOD | AR | 72120 | 710799771 | AMBUL SURG CTR | AR | N/A | N/A | 0 | 0 | |||||
| NORTHERN PLAINS LABORATORY LLC | |||||||||||||||
| 401 N 9 STREET | BISMARK | ND | 58501 | 841641341 | DIAGNOSTIC SERVICES | ND | N/A | N/A | 0 | 0 | |||||
| NSC CHANNEL ISLANDS LLC | |||||||||||||||
| 569 BROOKWOOD VILLAGE SUITE 901 | BIRMINGHAM | AL | 35209 | 770409291 | AMBULATORY SURGICAL CENTER | CA | N/A | N/A | 0 | 0 | |||||
| ORTHOCOLORADO LLC | |||||||||||||||
| 11650 WEST 2ND PLACE | LAKEWOOD | CO | 80228 | 371577105 | ORTHO HOSPITAL | CO | N/A | N/A | 0 | 0 | |||||
| PARK RAPIDS AREA HEALTH CARE | |||||||||||||||
| 600 PLEASANT AVENUE S | PARK RAPIDS | MN | 56470 | 204926259 | HEALTHCARE SRVC | MN | N/A | N/A | 0 | 0 | |||||
| PATIENT TRANSPORT SERVICES OF COLUMBUS INC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 264601285 | AMBULANCE | OH | N/A | N/A | 0 | 0 | |||||
| PENINSULA RADIATION ONCOLOGY CENTER LLC | |||||||||||||||
| 314 MLK JR WAY STE 11 | TACOMA | WA | 98405 | 870808610 | HEALTHCARE SRVC | WA | N/A | N/A | 0 | 0 | |||||
| PENRAD IMAGING LLC | |||||||||||||||
| 1390 KELLY JOHNSON BLVD | COLORADO SPRINGS | CO | 80920 | 841072619 | MEDICAL IMAGING | CO | N/A | N/A | 0 | 0 | |||||
| PERFORMANCE MED EQUIP & RESPIR SVSC LLC | |||||||||||||||
| 19625 62ND AVE S STE 101 | KENT | WA | 98032 | 452901632 | HOLDING COMPANY | WA | N/A | N/A | 0 | 0 | |||||
| PLAZA SURGERY CENTER LP | |||||||||||||||
| 525 E PLAZA DRIVE SUITE 100 | SANTA MARIA | CA | 93454 | 770573567 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||
| PMC HOSPITAL LLC | |||||||||||||||
| 3100 MAIN ST STE 500 | HOUSTON | TX | 77002 | 273280598 | HOSPITAL | TX | N/A | N/A | 0 | 0 | |||||
| PRECISION MEDICINE ALLIANCE LLC | |||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 352569159 | DIAGNOSTIC SERVICES | CO | N/A | N/A | 0 | 0 | |||||
| RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY | |||||||||||||||
| 1700 N ROSE AVENUE SUITE 120 | OXNARD | CA | 93030 | 770191706 | IMAGING | CA | N/A | N/A | 0 | 0 | |||||
| RBR MANAGEMENT LLC | |||||||||||||||
| 91 CORPORATE PARK DRIVE SUITE 120 | HENDERSON | NV | 89074 | 271466450 | AMBULANCE | NV | N/A | N/A | 0 | 0 | |||||
| REID-ANC HOME CARE SERVICES LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 371454747 | HOME HEALTH | IN | N/A | N/A | 0 | 0 | |||||
| SAINT JOSEPH - SCA HOLDINGS LLC | |||||||||||||||
| 1451 HARRODSBURG RD | LEXINGTON | KY | 40503 | 453801157 | INACTIVE | DE | N/A | N/A | 0 | 0 | |||||
| SAINT JOSEPH HEALTH ASC LLC | |||||||||||||||
| 1 SAINT JOSEPH DRIVE | LEXINGTON | KY | 40504 | 852155230 | SURGERY | KY | N/A | N/A | 0 | 0 | |||||
| SAINT JOSEPH-ANC HOME CARE SERVICES | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 263330545 | HOME HEALTH | KY | N/A | N/A | 0 | 0 | |||||
| SANTA CRUZ COMPREHENSIVE IMAGING LLC | |||||||||||||||
| 1661 SOQUEL DRIVE SUITE G | SANTA CRUZ | CA | 95065 | 010550623 | IMAGING | CA | N/A | N/A | 0 | 0 | |||||
| SANTA CRUZ LAND & BUILDING LP | |||||||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 95065 | 770285236 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | |||||
| SANTA CRUZ SURGERY CENTER LLC | |||||||||||||||
| 3003 PAUL SWEET ROAD | SANTA CRUZ | CA | 95065 | 770194916 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||
| SEVEN OAKS SURGERY CENTER LLC | |||||||||||||||
| 1801 ORANGE TREE LANE SUITE 200 | REDLANDS | CA | 92374 | 851559544 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||
| SOUTHEASTERN HOME CARE LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 271219638 | HOME HEALTH | OH | N/A | N/A | 0 | 0 | |||||
| ST JOSEPH'S SURGERY CENTER LP | |||||||||||||||
| 15305 DALLAS PARKWAY SUITE 1600 LB | ADDISON | TX | 75001 | 201019390 | SURGERY | TX | N/A | N/A | 0 | 0 | |||||
| ST ELIZABETH HOME CARE SERVICES LLC | |||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 261236191 | HOME HEALTH | KY | N/A | N/A | 0 | 0 | |||||
| ST FRANCIS LAND COMPANY | |||||||||||||||
| 5390 N ACADEMY BLVD STE 300 | COLORADO SPRINGS | CO | 80918 | 263134100 | REAL ESTATE | CO | N/A | N/A | 0 | 0 | |||||
| ST LUKE'S DIAGNOSTIC CATH LAB LLP | |||||||||||||||
| 6624 FANNIN ST STE 800 | HOUSTON | TX | 77030 | 710959365 | DIAGNOSTIC SERVICES | TX | N/A | N/A | 0 | 0 | |||||
| ST LUKE'S LAKESIDE HOSPITAL LLC | |||||||||||||||
| 6624 FANNIN STE 2505 | HOUSTON | TX | 77030 | 300427437 | HOSPITAL | TX | N/A | N/A | 0 | 0 | |||||
| ST LUKE'S THE WOODLANDS SLEEP CENTER LLC | |||||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 462795726 | DIAGNOSTIC SERVICES | TX | N/A | N/A | 0 | 0 | |||||
| TEMPLETON SURGERY CENTER LLC | |||||||||||||||
| 1310 LAS TABLAS ROAD SUITE 104 | TEMPLETON | CA | 94365 | 202246616 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||
| THE MEDICAL PAVILION AT ST JOHN'S | |||||||||||||||
| 1600 ROSE AVENUE | OXNARD | CA | 93030 | 770332349 | REAL ESTATE | CA | N/A | N/A | 0 | 0 | |||||
| THREE SPRING IMAGING LLC | |||||||||||||||
| 1 MERCADO ST STE 200A | DURANGO | CO | 81301 | 813571570 | HEALTHCARE SRVC | CO | N/A | N/A | 0 | 0 | |||||
| TIA ARIZONA LLC | |||||||||||||||
| 3030 N CENTRAL AVENUE SUITE 1402 | PHOENIX | AZ | 85012 | 863158670 | CLINIC | AZ | N/A | N/A | 0 | 0 | |||||
| VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC | |||||||||||||||
| 18330 ROSCOE BLVD | NORTHRIDGE | CA | 91328 | 800864336 | SURGERY | CA | N/A | N/A | 0 | 0 | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (62 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC | ||||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 470802396 | MANAGED CARE | NE | N/A | C | 0 | |||||
| ALL SAINTS INSURANCE COMPANY SPC LTD | ||||||||||||||
| 980556913 | INSURANCE | N/A | C | 0 | PO BOX 10073 APO | GEORGETOWN | GRAND CAYMAN | CJ | CJ | |||||
| ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC | ||||||||||||||
| 2801 FRANCISCAN DRIVE | BRYAN | TX | 77802 | 742466914 | HEALTHCARE | TX | N/A | C | 0 | |||||
| ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 841112049 | MANAGEMENT SERVICES | CO | N/A | C | 0 | |||||
| AMERICAN NURSING CARE INC | ||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311085414 | HOME HEALTH | OH | N/A | C | 0 | |||||
| AMERIMED INC | ||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311158699 | HOME HEALTH | OH | N/A | C | 0 | |||||
| BC HOLDING COMPANY INC | ||||||||||||||
| 1850 BLUEGRASS AVE | LOUISVILLE | KY | 40215 | 311542851 | INACTIVE | KY | N/A | C | 0 | |||||
| BRAZOSPORT HEALTH ALLIANCE | ||||||||||||||
| 1 WEST WAY COURT | LAKE JACKSON | TX | 77566 | 760518376 | HEALTHCARE | TX | N/A | C | 0 | |||||
| CADUCEUS MEDICAL ASSOCIATES INC | ||||||||||||||
| 5600 BRAINERD ROAD STE 500 | CHATTANOOGA | TN | 37411 | 621570736 | HEALTHCARE | TN | N/A | C | 0 | |||||
| CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 272269511 | RESEARCH | CO | N/A | C | 0 | |||||
| CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC | ||||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 834184717 | CONDO ASSOC | TX | N/A | C | 0 | |||||
| CLEARRIVER HEALTH | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464495960 | INSURANCE | TN | N/A | C | 0 | |||||
| COASTAL SURGICAL SPECIALISTS INC | ||||||||||||||
| 921 OAK PARK BLVD SUITE 101 | PISMO BEACH | CA | 93449 | 743000596 | AMBULATORY SURGERY CENTER | CA | N/A | S | 0 | |||||
| COMCARE SERVICES INC | ||||||||||||||
| 9100 E MINERAL CIRCLE | CENTENNIAL | CO | 80112 | 840904813 | INACTIVE | CO | N/A | C | 0 | |||||
| CONSOLIDATED HEALTH SERVICES | ||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311378212 | HOME HEALTH | OH | N/A | C | 0 | |||||
| DES MOINES MEDICAL CENTER INC | ||||||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 420837382 | REAL ESTATE | IA | N/A | C | 0 | |||||
| DIGNITY HEALTH HOLDING CORPORATION | ||||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 460675371 | HOLDING CO | NV | N/A | C | 0 | |||||
| DIGNITY HEALTH INSURANCE LTD | ||||||||||||||
| 981065338 | CAPTIVE INSURANCE | N/A | C | 0 | PO BOX 1051 | GRAND CAYMAN ISLANDS | GRAND CAYMAN | CJ | CJ | |||||
| DIGNITY HEALTH PROVIDER RESOURCES INC | ||||||||||||||
| 185 BERRY STREET SUITE 200 | SAN FRANCISCO | CA | 94107 | 473366764 | HEALTH PLAN | CA | N/A | C | 0 | |||||
| DIVERSIFIED HEALTH RESOURCES INC | ||||||||||||||
| 100 MEDICAL DRIVE | LAKE JACKSON | TX | 77566 | 760222679 | HEALTHCARE | TX | N/A | C | 0 | |||||
| FRANCISCAN CITY URGENT CARE SRVS PS | ||||||||||||||
| C/O CPGUSA 1345 AVE OF THE AMERICAS | NEW YORK | NY | 10105 | 812174959 | INACTIVE | NY | N/A | C | 0 | |||||
| FRANCISCAN SERVICES INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232487967 | HOLDING CO | CO | N/A | C | 0 | |||||
| GOOD SAMARITAN OUTREACH SERVICES | ||||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470659440 | MEDICAL CLINIC | NE | N/A | C | 0 | |||||
| HARVESTPLAINS HEALTH OF IOWA | ||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473451750 | INSURANCE | WA | N/A | C | 0 | |||||
| HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC | ||||||||||||||
| 1400 E CHURCH STREET | SANTA MARIA | CA | 93454 | 770074057 | HEALTHCARE | CA | N/A | C | 0 | |||||
| HEALTH SYSTEMS ENTERPRISES INC | ||||||||||||||
| PO BOX 1990 | KEARNEY | NE | 68848 | 470664558 | MGMT | NE | N/A | C | 0 | |||||
| HEALTHCARE MGMT SERVICES ORGANIZATION INC | ||||||||||||||
| 1149 MARKET ST | TACOMA | WA | 98402 | 911865474 | INACTIVE | WA | N/A | C | 0 | |||||
| HEARTLANDPLAINS HEALTH | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464368223 | INSURANCE | NE | N/A | C | 0 | |||||
| HIGHLINE MEDICAL GROUP | ||||||||||||||
| 1717 S J STREET | TACOMA | WA | 98405 | 911407026 | MEDICAL SERVICES | WA | N/A | C | 0 | |||||
| INTEGRATED MEDICAL SERVICES | ||||||||||||||
| 9250 N 3RD STREET SUITE 4010 | PHOENIX | AZ | 85020 | 860783428 | MULTI-SPECIALTY PHYSICIANS GROUP | AZ | N/A | C | 0 | |||||
| KOMG-LOUISVILLE REGION INC | ||||||||||||||
| 201 ABRAHAM FLEXNER WAY | LOUISVILLE | KY | 40202 | 832481198 | HEALTHCARE | KY | N/A | C | 0 | |||||
| MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC | ||||||||||||||
| 300 WERNER ST | HOT SPRINGS | AR | 71913 | 710720429 | REAL ESTATE | AR | N/A | C | 0 | |||||
| MEDQUEST | ||||||||||||||
| 1301 15TH AVENUE WEST | WILLISTON | ND | 58801 | 450392137 | SALE OF DME | ND | N/A | C | 0 | |||||
| MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC | ||||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 463622849 | INACTIVE | TX | N/A | C | 0 | |||||
| MERCY PARK APARTMENTS LTD | ||||||||||||||
| 1111 6TH AVE | DES MOINES | IA | 50314 | 421202422 | INACTIVE | IA | N/A | C | 0 | |||||
| MERCY SERVICES CORP | ||||||||||||||
| 2700 STEWART PARKWAY | ROSEBURG | OR | 97471 | 930824308 | RETAIL SALES | OR | N/A | C | 0 | |||||
| MHI CLINICAL SERVICES | ||||||||||||||
| 1201 W FRANK AVE | LUFKIN | TX | 75904 | 461967952 | HEALTHCARE | TX | N/A | C | 0 | |||||
| MILLENNIUM SURGERY CENTER INC | ||||||||||||||
| 9300 STOCKDALE HWY 200 | BAKERSFIELD | CA | 93311 | 770513445 | HEALTHCARE | CA | N/A | S | 0 | |||||
| MOUNTAIN MANAGEMENT SERVICES INC | ||||||||||||||
| 6028 SHALLOWFORD RD | CHATTANOOGA | TN | 37421 | 621570739 | MGMT SVC ORG | TN | N/A | C | 0 | |||||
| NORTH CENTRAL HEALTH CARE ALLIANCE | ||||||||||||||
| PO BOX 5538 | BISMARK | ND | 58506 | 450439894 | HEALTHCARE | ND | N/A | C | 0 | |||||
| PATIENT TRANSPORT SERVICES INC | ||||||||||||||
| 1700 EDISON DR | MILFORD | OH | 45150 | 311100798 | HOME HEALTH | OH | N/A | C | 0 | |||||
| QUALCHOICE ADVANTAGE | ||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 473433912 | INSURANCE | WA | N/A | C | 0 | |||||
| QUALCHOICE HEALTH PLAN SERVICES INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 461224037 | ADMIN SERVICES | CO | N/A | C | 0 | |||||
| QUALCHOICE HEALTH INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 461222808 | HOLDING CO | CO | N/A | C | 0 | |||||
| QUALCHOICE HOLDINGS INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 274075520 | HOLDING CO | AR | N/A | C | 0 | |||||
| QUALCHOICE OF NEBRASKA | ||||||||||||||
| 2401 S 73RD ST | OMAHA | NE | 68124 | 810738827 | INACTIVE | NE | N/A | C | 0 | |||||
| RIVERLINK HEALTH | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464380824 | INSURANCE | OH | N/A | C | 0 | |||||
| RIVERLINK HEALTH OF KENTUCKY INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 464828332 | INSURANCE | KY | N/A | C | 0 | |||||
| ROSS PARK PHARMACY INC | ||||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341832654 | PHARMACY | OH | N/A | C | 0 | |||||
| SAINT CLARE'S PRIMARY CARE INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 222441202 | INACTIVE | NJ | N/A | C | 0 | |||||
| SJH SERVICES CORPORATION | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 232307408 | INACTIVE | CO | N/A | C | 0 | |||||
| SJL PHYSICIAN MANAGEMENT SERVICES INC | ||||||||||||||
| 424 LEWIS HARGETT CR STE 160 | LEXINGTON | KY | 40503 | 270164198 | INACTIVE | KY | N/A | C | 0 | |||||
| SOUNDPATH HEALTH INC | ||||||||||||||
| 32129 WEYERHAEUSER WAY S STE 201 | FEDERAL WAY | WA | 98001 | 421720801 | INSURANCE | WA | N/A | C | 0 | |||||
| ST MARY HEALTH VENTURES INC | ||||||||||||||
| 1050 LINDEN AVENUE | LONG BEACH | CA | 90813 | 951912528 | RETAIL PHARMACY | CA | N/A | C | 0 | |||||
| ST ANTHONY DEVELOPMENT COMPANY | ||||||||||||||
| 1415 SOUTHGATE | PENDLETON | OR | 97801 | 931216943 | ATHLETIC CLUB | OR | N/A | C | 0 | |||||
| ST JOSEPH DEVELOPMENT COMPANY INC | ||||||||||||||
| 1717 SOUTH J ST | TACOMA | WA | 98405 | 911480569 | RENTAL | WA | N/A | C | 0 | |||||
| ST LUKE'S HEALTH SYSTEM HOLDINGS INC | ||||||||||||||
| 6624 FANNIN STE 800 | HOUSTON | TX | 77030 | 760637138 | HOLDING CO | TX | N/A | C | 0 | |||||
| ST VINCENT COMMUNITY HEALTH SERVICES INC | ||||||||||||||
| TWO ST VINCENT CIRCLE | LITTLE ROCK | AR | 72205 | 710710785 | HEALTHCARE | AR | N/A | C | 0 | |||||
| STE HOLDINGS | ||||||||||||||
| 12809 WEST DODGE RD | OMAHA | NE | 68154 | 822383629 | HOLDING CO | NE | N/A | C | 0 | |||||
| SUGAR LAND DOCTOR GROUP | ||||||||||||||
| 1317 LAKE POINT PARKWAY | SUGAR LAND | TX | 77478 | 454270163 | INACTIVE | TX | N/A | C | 0 | |||||
| TOWSON MANAGEMENT INC | ||||||||||||||
| 198 INVERNESS DRIVE WEST | ENGLEWOOD | CO | 80112 | 521710750 | INACTIVE | MD | N/A | C | 0 | |||||
| TRINITY MANAGEMENT SERVICES ORGANIZATION | ||||||||||||||
| 380 SUMMIT AVE | STEUBENVILLE | OH | 43952 | 341471026 | MGMT SERVICES | OH | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |